Positive experience in treating patients with Duchenne muscular dystrophy caused by a nonsense mutation: family clinical case

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Abstract

Duchenne muscular dystrophy is a severe genetic disease caused by mutations in the dystrophin gene (DMD), which lead to a significant decrease or complete absence of the protein of the same name in muscle fibers. The disease manifests itself in boys from the age of 2–5 years in the form of progressive muscular weakness, cardiomyopathy and respiratory failure. As a result of progression, patients lose the ability to move by adolescence and die in the third decade from cardiopulmonary complications. However, timely pathogenetic therapy for Duchenne muscular dystrophy can prolong the life of patients and improve its quality. In this regard, early diagnosis of the disease and early initiation of pathogenetic therapy are very important.

The article describes two clinical cases of the disease in siblings with onset at 2 years of age and different ages of diagnosis. Pathogenetic therapy in the first case made it possible to prolong the patient’s outpatient stay and improve the quality of life, and early diagnosis and initiation of pathogenetic therapy in the second case avoided disease progression and contributed to the development of new motor skills. The presented clinical case demonstrates the need for early diagnosis of the disease even before the onset of clinical manifestations.

About the authors

L. S. Kraeva

Siberian State Medical University, Ministry of Health of Russia

Author for correspondence.
Email: lskraeva@yandex.ru
ORCID iD: 0000-0002-1614-3749

Ljudmila Sergeevna Kraeva

2 Moskovskiy Trakt, Tomsk 634050

Russian Federation

E. V. Fadeeva

Children’s Hospital No. 1

Email: fake@neicon.ru
ORCID iD: 0009-0003-6537-0993

4 Moskovskiy Trakt, Tomsk 634050

Russian Federation

References

  1. Clinical guidelines “Progressive Duchenne muscular dystrophy. Progressive Becker muscular dystrophy”. Available at: https://cr.minzdrav.gov.ru/recomend/773_1/. (In Russ.).
  2. Birnkrant D.J., Bushby K., Bann C.M. et al. Care Considerations Working Group. Diagnosis and management of Duchenne muscular dystrophy, part 1: Diagnosis, and neuromuscular, rehabilitation, endocrine, and gastrointestinal and nutritional management. Lancet Neurol 2018;17(3):251–67. doi: 10.1016/S1474-4422(18)30024-3
  3. Bushby K., Finkel R., Birnkrant D.J. et al. Diagnosis and management of Duchenne muscular dystrophy, part 1: Diagnosis, and pharmacological and psychosocial management. Lancet Neurol 2010;9:77–93. doi: 10.1016/S1474-4422(09)70271-6
  4. Fox H., Millington L., Mahabeer I., van Ruiten H. Duchenne muscular dystrophy. BMJ 2020;368:l7012. doi: 10.1136/bmj.l7012
  5. Mercuri E., Muntoni F. Muscular dystrophies. Lancet 2013;381:845–60. doi: 10.1016/S0140-6736(12)61897-2
  6. Swiderski K., Hardee J.P., Lynch G.S. Regenerative rehabilitation for Duchenne muscular dystrophy. In: Regenerative Rehabilitation: From Basic Science to the Clinic. Cham: Springer International Publishing, 2022. Pp. 85–119. doi: 10.1007/978-3-030-95884-8_4

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