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Single-centre experience on genotypic and phenotypic features of southern Brazilian patients with McArdle disease

  • Paulo José Lorenzoni
  • Lineu Cesar Werneck
  • Cláudia Suemi Kamoi Kay
  • Raquel Cristina Arndt
  • Carlos E. S. Silvado
  • Rosana Herminia Scola
Original Article
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Abstract

McArdle disease (MD) is a metabolic myopathy caused by deficiency of the myophosphorylase enzyme. The aim of our study was to analyse a series of MD patients in Brazil and the correlation between clinical findings, laboratory data, electromyography, muscle biopsy and genetic features. The PYGM gene was analysed by PCR/RLFP and Sanger sequencing. The sample included 12 patients, aged 18–57 years, from unrelated families. Exercise intolerance was present in all cases. Serum creatine kinase levels at rest were increased in all patients. Forearm ischaemic exercise testing in five patients revealed no increase in venous lactate. Needle electromyography presented ‘myopathic pattern’ in six patients. Muscle biopsy showed vacuolar myopathy in 10 patients and deficiency of myophosphorylase enzyme in all patients. The genetic analysis showed p.R50X as the most common mutation (allelic frequency: 56.25%), other known mutations (p.Y574X, p.G205S, p.W798R, IVS14 + 1G > A and IVS19-1G > A) and a new mutation (p.Asn168Lysfs*15) were also identified. Several features of the disorder were similar to the vast majority of patients worldwide. The genetic findings of this study revealed a range of mutations that are quite similar to the European cohort. The discovery of one novel mutation increases the genotypic heterogeneity of PYGM gene.

Keywords

McArdle disease Metabolic myopathy Myophosphorylase Glycogen storage disease Glycogenosis type V 

Notes

Funding

This study was supported by UFPR, Fundação Araucária, CAPES and CNPq.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The study was approved by the Local Ethics Committee for Human Research.

Informed consent

All studies were conducted in accordance with ethical principles after obtaining patient consent.

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Copyright information

© Belgian Neurological Society 2018

Authors and Affiliations

  • Paulo José Lorenzoni
    • 1
  • Lineu Cesar Werneck
    • 1
  • Cláudia Suemi Kamoi Kay
    • 1
  • Raquel Cristina Arndt
    • 1
  • Carlos E. S. Silvado
    • 1
  • Rosana Herminia Scola
    • 1
  1. 1.Service of Neuromuscular Disorders, Division of Neurology, Department of Internal Medicine, Hospital de ClínicasUniversidade Federal do Paraná (UFPR)CuritibaBrazil

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