Duchenne Muscular Dystrophy in a Filipino Boy Reaching Adulthood, and Nine Years into Oral Corticosteroids: A Case Report
Erwin Damian V. Marcelo, Raymond L. Rosales
Apr 2023 DOI 10.35460/2546-1621.2023-0022 Access
Abstract
Rationale: Duchenne muscular dystrophy (DMD) is a disease that primarily manifests in the early stages of life and progressively affects muscle strength resulting in quadriparesis and ultimately resulting in premature death secondary to cardiac or respiratory failure. DMD is the most common x-linked genetic disorder in children that is because of an alteration of a protein called “dystrophin” which is responsible for strengthening muscle fibers and protecting them from injury as muscles contract and relax.
Objective: To highlight the case of a 19-year-old male who was diagnosed with DMD at 8 years of age and treated with oral corticosteroid and rehabilitation.
Case: We present the case of a 19-year-old male who developed difficulty climbing stairs and was diagnosed with DMD at 8 years old with the use of clinical exome sequencing. Corticosteroid therapy was initiated and rehabilitation perpetuated which dramatically improved his life expectancy.
Discussion and Summary: Clinical exome sequencing was employed on our patient to confirm the diagnosis of DMD from other neuromuscular and neurodegenerative diseases. Most cases of DMD succumb to cardiopulmonary arrest before reaching adulthood; however, this case exemplifies DMD from other cases since our patient was able to prolong his life with continuation of oral corticosteroid and rehabilitation and in the absence of extensive life support.
Key words: Progressive muscle weakness, Dystrophin, Premature death, DMD
- Hoffman EP, Dressman D. Molecular pathophysiology and targeted therapeutics for muscular dystrophy. Trends Pharmacol Sci [Internet]. 2001;22(9):465–70. Available from: http://dx.doi.org/10.1016/s0165-6147(00)01770-3
- Ryder S, Leadley RM, Armstrong N, Westwood M, de Kock S, Butt T, et al. The burden, epidemiology, costs and treatment for Duchenne muscular dystrophy: an evidence review. Orphanet J Rare Dis [Internet]. 2017;12(1). Available from: http://dx.doi.org/10.1186/s13023-017-0631-3
- Kingman R. Nelson Textbook of Pediatrics. 20th Ed. p.2976-9.
- Landfeldt E, Thompson R, Sejersen T, McMillan HJ, Kirschner J, Lochmüller H. Life expectancy at birth in Duchenne muscular dystrophy: a systematic review and meta-analysis. Eur J Epidemiol [Internet]. 2020;35(7):643–53. Available from: http://dx.doi.org/10.1007/s10654-020-00613-8
- Beytía M de LA, Vry J, Kirschner J. Drug treatment of Duchenne muscular dystrophy: available evidence and perspectives. Acta Myol. 2012;31(1):4–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440798/
- Takeuchi F, Nakamura H, Yonemoto N, Komaki H, Rosales RL, Kornberg AJ, et al. Clinical practice with steroid therapy for Duchenne muscular dystrophy: An expert survey in Asia and Oceania. Brain Dev [Internet]. 2020;42(3):277–88. Available from: http://dx.doi.org/10.1016/j.braindev.2019.12.005
- NIAMS. Optimizing steroid treatment for Duchenne muscular dystrophy [Internet]. National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2018 [cited 2023 Apr 11]. Available from: https://www.niams.nih.gov/newsroom/spotlight-on-research/optimizing-steroid-treatment-duchenne-muscular-dystrophy
Articles related to the one you are viewing
There are currently no results to show, please try again later
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, which permits use, share — copy and redistribute the material in any medium or format, adapt — remix, transform, and build upon the material, as long as you give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original. You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-sa/4.0/.