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Nemaline Myopathy Associated with Monoclonal Gammopathy –  a Case Report


Authors: M. Forgáč 1;  T. Uher 1;  J. Zámečník 2
Authors‘ workplace: Neurologická klinika 1. LF UK a VFN v Praze 1;  Ústav patologie a molekulární medicíny 2. LF UK a FN v Motole, Praha 2
Published in: Cesk Slov Neurol N 2014; 77/110(2): 247-250
Category: Case Report

Práce byla podpořena granty VZ MŠM 0021620849, PRVOUK‑ P26/ LF/ 4 a projektem (Ministerstva zdravotnictví ČR) koncepčního rozvoje výzkumné organizace 00064203 (FN Motol).

Overview

Nemaline (rod) myopathy is an uncommon muscle disease with a wide spectrum of phenotypes. Since 1966 until 2008, 71 patients with sporadic late‑ onset nemaline myopathy have been described. Among them, 12 had monoclonal gammopathy. This case report describes a 64‑year‑ old man with IgG kappa monoclonal gammopathy of undetermined significance, who developed progressive muscle weakness and symmetric hypotrophy, mainly of the proximal limb muscles a year after dia­gnosis. Muscle bio­psy and electron microscopy revealed the presence of numerous typical rod‑ shaped inclusions in muscle fibers and the dia­gnosis of nemaline myopathy was established. The patient did not respond to therapy with corticosteroids, application of IVIG had also been considered. The case report is supplemented with basic information related to sporadic late‑ onset nemaline myopathy.

Key words:
nemaline myopathy – monoclonal gammopathy – muscle biopsy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


Sources

1. Shy GM, Engel WK, Somers JE, Wanko T. Nemaline myopathy: a new congenital myopathy. Brain 1963; 86: 793– 810.

2. Conen PE, Murphy EG, Donohue WL. Light and electron microscopic studies of „myogranules“ in a child with hypotonia and muscle weakness. Can Med Assoc J 1963; 89: 983– 986.

3. Bednařík J, Voháňka S, Lukáš Z, Kadaňka Z, Vytopil M,Mechl M et al. Nemoci kosterního svalstva. Praha: Triton 2001: 182– 183.

4. Fardeau M. Congenital myopathies. In: Mastaglia FL,Walton J (eds). Skeletal Muscle Pathology. 2nd ed. Edinburgh: Churchill Livingstone 1992: 237– 281.

5. Banker BQ. The congenital myopathies. In: Engel AG,Banker BQ (eds). Myology. New York: McGraw‑ Hill 1986: 1527– 1581.

6. Benveniste O, Laforet P, Dubourg O, Solly S, Musset L, Choquet S et al. Stem cell transplantation in a patient with late‑ onset nemaline myopathy and gammopathy. Neurology 2008; 71(7): 531– 532. doi: 10.1212/ 01.wnl.0000310813.79325.32.

7. Wallgren‑ Pettersson C, Sewry CA, Nowak KJ, Laing NG. Nemaline myopathies. Semin Pediatr Neurol 2011; 18(4): 230– 238. doi: 10.1016/ j.spen.2011.10.004.

8. Engel WK, Oberc MA. Abundant nuclear rods in adult‑ onset rod disease. J Neuropathol Exp Neurol 1975; 34(2): 119– 132.

9. Paulus W, Peiffer J, Becker I, Roggendorf W, Schumm F. Adult‑ onset rod disease with abundant intranuclear rods. J Neurol 1988; 235(6): 343– 347.

10. Yamaguchi M, Robson RM, Stromer MH, Dahl DS,Oda T. Actin filaments form the backbone of nemaline myopathy rods. Nature 1978; 271(5642): 265– 267.

11. Shimomura C, Nonaka I. Nemaline myopathy: comparative muscle histochemistry in the severe neonatal, moderate congenital, and adult‑ onset forms. Pediatr Neurol 1989; 5(1): 25– 31.

12. Engel WK, Resnick JS. Late rod myopathy: a newly recognized acquired and progressive disease. Neurology 1966; 16: 308– 309.

13. Engel AG. Late‑ onset rod myopathy (a new syndrome?): light and electron microscopic observations in two cases. Mayo Clin Proc 1966; 41(11): 713– 741.

14. Milone M, Katz A, Amato AA, Soderland CA, Segarceanu M, Young NP et al. Sporadic late onset nemaline myopathy responsive to IVIg and immunotherapy. Muscle Nerve 2010; 41(2): 272– 276. doi: 10.1002/ mus.21504.

15. Wengert O, Meisel A, Kress W, Dekomien G, Angstwurm K, Heppner FL et al. Progressive external ophthalmoplegia as initial manifestation of sporadic late‑ onset nemaline myopathy. J Neurol 2011; 258(5): 915– 917. doi: 10.1007/ s00415– 010– 5819– 6.

16. Chahin N, Selcen D, Engel AG. Sporadic late onset nemaline myopathy. Neurology 2005; 65(8): 1158– 1164.

17. Agrawal PB, Strickland CD, Midgett C, Morales A, Newburger DE, Poulos MA et al. Heterogeneity of nemaline myopathy cases with skeletal muscle alpha‑ actin gene mutations. Ann Neurol 2004; 56(1): 86– 96.

18. Lomen‑ Hoerth C, Simmons ML, Dearmond SJ, Layzer RB. Adult‑ onset nemaline myopathy: another cause of dropped head. Muscle Nerve 1999; 22(8): 1146– 1150.

19. Voermans NC, Minnema M, Lammens M, Schelhaas HJ, Kooi AV, Lokhorst HM et al. Sporadic late‑ onset nemaline myopathy effectively treated by melphalan and stem cell transplant. Neurology 2008; 71(7): 532– 534. doi: 10.1212/ 01.wnl.0000310814.54623.6f.

20. Danon MJ, Giometti CS, Manaligod JR, Perurena OH,Skosey JL. Adult‑ onset nemaline rods in a patient treated for suspected dermatomyositis. Study with two‑dimensional electrophoresis. Arch Neurol 1981; 38(12): 761– 766.

21. Cape CA, Johnson WW, Pitner SE. Nemaline structures in polymyositis. A nonspecific pathological reaction of skeletal muscles. Neurology 1970; 20(5): 494– 502.

22. Martinez AJ, Hooshmand H, Faris AA. Acute alcoholic myopathy. Enzyme histochemistry and electron microscopic findings. J Neurol Sci 1973; 20(3): 245– 252.

23. Reyes MG, Tal A, Abrahamson D, Schwartz M. Nemaline myopathy in an adult with primary hypothyroidism. Can J Neurol Sci 1986; 13(2): 117– 119.

24. Konno H, Iwasaki Y, Yamamoto T, Inosaka T. Nemaline bodies in spinal progressive muscular atrophy. An autopsy case. Acta Neuropathol 1987; 74(1): 84– 88.

Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

Issue 2

2014 Issue 2

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