Table 1 Phenotypic features of myoglobinopathy
Family 1 | Family 2 | Family 3 | Family 4 | Family 5 | Family 6 | |
|---|---|---|---|---|---|---|
Inheritance pattern | AD | AD | AD | AD | unknown | unknown |
Myoglobin mutation | His98Tyr | His98Tyr | His98Tyr | His98Tyr | His98Tyr | His98Tyr |
Country of origin | Spain | Spain | Sweden | France | France | Netherlands |
No. of patients | 2 | 1 | 6 | 3 | 1 | 1 |
Mean age of onset (range) | 37.5 (36–39) | 38 | 44.5 (39–49) | 46 (44–48) | 40 | 33 |
Gender (female/male) | 0/2 | 1/0 | 2/4 | 2/1 | 0/1 | 0/1 |
Initial symptoms | Proximal LL and axial weakness (2/2) | Proximal LL and axial weakness (1/1) | Distal hand weakness (2/6) Proximal LL and axial weakness (6/6) | Proximal LL and axial weakness (3/3) | Proximal LL weakness (1/1) | Proximal LL and axial weakness (1/1) |
Symptoms at advanced disease | ||||||
Distribution of weakness | Proximal and axial > distal 4 EE | Proximal and axial > distal 4 EE | Proximal and axial > distal 4 EE | Proximal and distal 4 EE > axial | Proximal and axial > distal 4 EE | Proximal and axial > distal legs |
Involvement of hand muscles | 2/2 | 1/1 | 6/6 | 2/2** | 1/1 | 0/1 |
Facial weakness | 0/2 | 0/1 | 0/6 | 0/2 | 0/1 | 0/1 |
Muscle atrophy | 2/2 | 1/1 | 6/6 | 2/2 | 0/1 | 1/1 |
Dysphagia | 2/2 | 0/1 | 2/4 | 0/2 | 1/1 | 0/1 |
Respiratory insufficiency | 2/2 | 1/1 | 2/6 | 1/2 | 1/1 | 1/1 |
Cardiac involvement* | 2/2 | 1/1 | 2/6 | 0/2 | 1/1 | 0/1 |
Clinical outcome | ||||||
Mean age at wheelchair dependency | 54 | 65 | 56 (4/6 patients wheelchair dependent, 2/6 ambulant) | 66 (1/3 patients wheelchair dependent, 2/3 ambulant) | 56 | 47 |
Mean age at death (range) | 60.5 (54–67) | – | 64 (58–71) | 72 | – | – |
Laboratory studies | ||||||
CK fold elevation above normal levels | 1.5–2 | 2 | 1.5–4 | 2.3–3.7 | 4 | 3.5–7 |
EMG | Myogenic with spontaneous activity at rest | Myogenic with spontaneous activity at rest | Myogenic with spontaneous activity at rest | Myogenic with spontaneous activity at rest | Myogenic with spontaneous activity at rest | Myogenic with spontaneous activity at rest |