Abstract
Objective: To report a family with Marfan's syndrome in whom a myopathy was associated with respiratory failure; muscle biopsies from affected individuals were examined to determine whether there were abnormalities in fibrillin.
Methods: 21 family members underwent detailed clinical examination, including neurological and pulmonary assessment. Muscle biopsies in the most severely affected cases were immunostained using monoclonal antibodies to specific fibrillin components. Genomic DNA from all 21 members was analysed for mutations in the fibrillin gene, FBN1, on 15q21.
Results: 13 individuals had a C4621T base change in exon 37 of the FBN1 gene, which in four cases segregated with muscle weakness or evidence of respiratory muscle dysfunction or both. Their muscle biopsies revealed an abnormality in fibrillin immunoreactivity.
Conclusions: Abnormalities in fibrillin can be detected in muscle biopsies from patients with Marfan's syndrome who have myopathy. This pedigree, with a point mutation in FBN1, also draws attention to the potential for respiratory failure associated with myopathy.
Full Text
The Full Text of this article is available as a PDF (181.4 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Barrison I. G., Isenberg D. A., Kane S. P. Arachnodactyly with unusual neuromyopathic and skeletal abnormalities. J R Soc Med. 1980 Jan;73(1):64–68. doi: 10.1177/014107688007300116. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Behan W. M., More I. A., Behan P. O. Mitochondrial abnormalities in the postviral fatigue syndrome. Acta Neuropathol. 1991;83(1):61–65. doi: 10.1007/BF00294431. [DOI] [PubMed] [Google Scholar]
- Beighton P., de Paepe A., Danks D., Finidori G., Gedde-Dahl T., Goodman R., Hall J. G., Hollister D. W., Horton W., McKusick V. A. International Nosology of Heritable Disorders of Connective Tissue, Berlin, 1986. Am J Med Genet. 1988 Mar;29(3):581–594. doi: 10.1002/ajmg.1320290316. [DOI] [PubMed] [Google Scholar]
- Collod G., Babron M. C., Jondeau G., Coulon M., Weissenbach J., Dubourg O., Bourdarias J. P., Bonaïti-Pellié C., Junien C., Boileau C. A second locus for Marfan syndrome maps to chromosome 3p24.2-p25. Nat Genet. 1994 Nov;8(3):264–268. doi: 10.1038/ng1194-264. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cunliffe W. J., Hudgson P., Fulthorpe J. J., Black M. M., Hall R., Johnston I. D., Shuster S. A calcitonin-secreting medullary thyroid carcinoma associated with mucosal neuromas, marfanoid features, myopathy and pigmentation. Am J Med. 1970 Jan;48(1):120–126. doi: 10.1016/0002-9343(70)90106-3. [DOI] [PubMed] [Google Scholar]
- De Paepe A., Devereux R. B., Dietz H. C., Hennekam R. C., Pyeritz R. E. Revised diagnostic criteria for the Marfan syndrome. Am J Med Genet. 1996 Apr 24;62(4):417–426. doi: 10.1002/(SICI)1096-8628(19960424)62:4<417::AID-AJMG15>3.0.CO;2-R. [DOI] [PubMed] [Google Scholar]
- De Paepe A. Dural ectasia and the diagnosis of Marfan's syndrome. Lancet. 1999 Sep 11;354(9182):878–879. doi: 10.1016/S0140-6736(99)00168-3. [DOI] [PubMed] [Google Scholar]
- Dietz H. C., Cutting G. R., Pyeritz R. E., Maslen C. L., Sakai L. Y., Corson G. M., Puffenberger E. G., Hamosh A., Nanthakumar E. J., Curristin S. M. Marfan syndrome caused by a recurrent de novo missense mutation in the fibrillin gene. Nature. 1991 Jul 25;352(6333):337–339. doi: 10.1038/352337a0. [DOI] [PubMed] [Google Scholar]
- Dietz H. C., McIntosh I., Sakai L. Y., Corson G. M., Chalberg S. C., Pyeritz R. E., Francomano C. A. Four novel FBN1 mutations: significance for mutant transcript level and EGF-like domain calcium binding in the pathogenesis of Marfan syndrome. Genomics. 1993 Aug;17(2):468–475. doi: 10.1006/geno.1993.1349. [DOI] [PubMed] [Google Scholar]
- Dietz H. C., Ramirez F., Sakai L. Y. Marfan's syndrome and other microfibrillar diseases. Adv Hum Genet. 1994;22:153–186. doi: 10.1007/978-1-4757-9062-7_4. [DOI] [PubMed] [Google Scholar]
- Eymard B., Tomé F. M., Brunet P., Fardeau M. Maladie de Marfan et neuropathie tomaculaire familiale. Un cas d'association fortuite. Rev Neurol (Paris) 1986;142(8-9):703–705. [PubMed] [Google Scholar]
- Gibson M. A., Finnis M. L., Kumaratilake J. S., Cleary E. G. Microfibril-associated glycoprotein-2 (MAGP-2) is specifically associated with fibrillin-containing microfibrils but exhibits more restricted patterns of tissue localization and developmental expression than its structural relative MAGP-1. J Histochem Cytochem. 1998 Aug;46(8):871–886. doi: 10.1177/002215549804600802. [DOI] [PubMed] [Google Scholar]
- Goebel H. H., Muller J., DeMyer W. Myopathy associated with Marfan's syndrome. Fine structural and histochemical observations. Neurology. 1973 Dec;23(12):1257–1268. doi: 10.1212/wnl.23.12.1257. [DOI] [PubMed] [Google Scholar]
- Gross M. L., Teoh R., Legg N. J., Pallis C. Ocular myopathy and Marfan's syndrome. A family study. J Neurol Sci. 1980 Apr;46(1):105–112. doi: 10.1016/0022-510x(80)90047-7. [DOI] [PubMed] [Google Scholar]
- Halliday D., Hutchinson S., Kettle S., Firth H., Wordsworth P., Handford P. A. Molecular analysis of eight mutations in FBN1. Hum Genet. 1999 Dec;105(6):587–597. doi: 10.1007/s004399900190. [DOI] [PubMed] [Google Scholar]
- Hecht F., Beals R. K. "New" syndrome of congenital contractural arachnodactyly originally described by Marfan in 1896. Pediatrics. 1972 Apr;49(4):574–579. [PubMed] [Google Scholar]
- Hudgson P., Gardner-Medwin D., Fulthorpe J. J., Walton J. N. Nemaline myopathy. Neurology. 1967 Dec;17(12):1125–1142. doi: 10.1212/wnl.17.12.1125. [DOI] [PubMed] [Google Scholar]
- Jadro-Santel D., Grcević N., Dogan S., Franjić J., Benc H. Centronuclear myopathy with type I fibre hypotrophy and "fingerprint" inclusions associated with Marfan's syndrome. J Neurol Sci. 1980 Feb;45(1):43–56. doi: 10.1016/s0022-510x(80)80005-0. [DOI] [PubMed] [Google Scholar]
- Joyce D. A., Mastaglia F. L., Ojeda V. J., Spagnolo D. V. Familial myopathy associated with Marfanoid features and multicores. Aust N Z J Med. 1984 Aug;14(4):495–499. doi: 10.1111/j.1445-5994.1984.tb03626.x. [DOI] [PubMed] [Google Scholar]
- Kumar P., Gupta D., Sagar R. K. A rare combination of Marfan's syndrome, rheumatic heart disease and muscular dystrophy--a case report. Indian Heart J. 1994 Nov-Dec;46(6):351–352. [PubMed] [Google Scholar]
- Loeys B., Nuytinck L., Delvaux I., De Bie S., De Paepe A. Genotype and phenotype analysis of 171 patients referred for molecular study of the fibrillin-1 gene FBN1 because of suspected Marfan syndrome. Arch Intern Med. 2001 Nov 12;161(20):2447–2454. doi: 10.1001/archinte.161.20.2447. [DOI] [PubMed] [Google Scholar]
- Mátyás Gábor, De Paepe Anne, Halliday Dorothy, Boileau Catherine, Pals Gerard, Steinmann Beat. Evaluation and application of denaturing HPLC for mutation detection in Marfan syndrome: Identification of 20 novel mutations and two novel polymorphisms in the FBN1 gene. Hum Mutat. 2002 Apr;19(4):443–456. doi: 10.1002/humu.10054. [DOI] [PubMed] [Google Scholar]
- Nijbroek G., Sood S., McIntosh I., Francomano C. A., Bull E., Pereira L., Ramirez F., Pyeritz R. E., Dietz H. C. Fifteen novel FBN1 mutations causing Marfan syndrome detected by heteroduplex analysis of genomic amplicons. Am J Hum Genet. 1995 Jul;57(1):8–21. [PMC free article] [PubMed] [Google Scholar]
- Pagès M., Echenne B., Pagès A. M., Dimeglio A., Sires A. Multicore disease and Marfan's syndrome: a case report. Eur Neurol. 1985;24(3):170–175. doi: 10.1159/000115842. [DOI] [PubMed] [Google Scholar]
- Pereira L., Levran O., Ramirez F., Lynch J. R., Sykes B., Pyeritz R. E., Dietz H. C. A molecular approach to the stratification of cardiovascular risk in families with Marfan's syndrome. N Engl J Med. 1994 Jul 21;331(3):148–153. doi: 10.1056/NEJM199407213310302. [DOI] [PubMed] [Google Scholar]
- Putnam E. A., Zhang H., Ramirez F., Milewicz D. M. Fibrillin-2 (FBN2) mutations result in the Marfan-like disorder, congenital contractural arachnodactyly. Nat Genet. 1995 Dec;11(4):456–458. doi: 10.1038/ng1295-456. [DOI] [PubMed] [Google Scholar]
- Pyeritz R. E., McKusick V. A. The Marfan syndrome: diagnosis and management. N Engl J Med. 1979 Apr 5;300(14):772–777. doi: 10.1056/NEJM197904053001406. [DOI] [PubMed] [Google Scholar]
- Pyeritz R. E. The Marfan syndrome. Annu Rev Med. 2000;51:481–510. doi: 10.1146/annurev.med.51.1.481. [DOI] [PubMed] [Google Scholar]
- Robinson P. N., Godfrey M. The molecular genetics of Marfan syndrome and related microfibrillopathies. J Med Genet. 2000 Jan;37(1):9–25. doi: 10.1136/jmg.37.1.9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sakai L. Y., Keene D. R., Engvall E. Fibrillin, a new 350-kD glycoprotein, is a component of extracellular microfibrils. J Cell Biol. 1986 Dec;103(6 Pt 1):2499–2509. doi: 10.1083/jcb.103.6.2499. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zhang H., Hu W., Ramirez F. Developmental expression of fibrillin genes suggests heterogeneity of extracellular microfibrils. J Cell Biol. 1995 May;129(4):1165–1176. doi: 10.1083/jcb.129.4.1165. [DOI] [PMC free article] [PubMed] [Google Scholar]