Table II.
Clinical characteristics | Proband (II-1) | Proband's younger sister (II-2) | Proband's mother (I-2) |
---|---|---|---|
Age, years | 16 | 14 | 42 |
Sex | Male | Female | Female |
Age of onset, years | 8 | 7 | 14 |
Clinical symptoms | Difficulty in standing, walking, climbing stairs, walking unaided for <15 min and inability to raise arms above head. | Difficulty in standing, walking, climbing stairs or running with frequent falls, exercise intolerance, and difficulty rising from the floor or standing from the sitting position independently. | Difficulty in running, climbing stairs, walking independently, lifting weights, standing up from sitting position and a waddling gait. |
Neurological examination | Severe weakness of the proximal muscles of all limbs, pelvic and shoulder girdles. | Weakness and atrophy of limb-girdle muscles. | Weakness and atrophy of limb-girdle muscles. |
Muscle weakness and atrophy | Bilateral atrophy of the biceps, shoulder muscles, hip adductors, posterior thigh muscles and knee flexors and moderate hypertrophy on both sides of the calves and scapular winging. | Diffuse atrophy in all upper and lower leg muscles. | Typical myopathic right biceps, severe atrophy of lower limbs and atrophy of paraspinal muscle, back pain, hyperlordosis and myalgia. |
Muscle power (MRC Scale) | Proximal upper and lower extremities were grade 3, while distal upper and lower extremities were 4+. | Proximal upper and lower extremities and proximal lower extremities were grade 3 and 2, respectively. | Proximal upper and lower extremities were grade 2, and distal upper and lower extremities were grade 2. |
Deep tendon reflexes | Normal in arms; absent in lower extremities | Absent or diffusely reduced in lower extremities. | Absent of all. |
Gowers' sign | Present with decreasing plantar reflexes. | Present with pelvic girdle and leg muscle atrophy. | Present with limb-girdle muscle atrophy. |
Creatine kinase levels, IU/l | 4,754 | 1,050 | 2,000 |
MRC, medical research council.