Gene analysis and clinical features of 22 GNE myopathy patients

Neurol Sci. 2022 Aug;43(8):5049-5056. doi: 10.1007/s10072-022-06023-w. Epub 2022 Apr 19.

Abstract

Introduction: GNE myopathy is an autosomal recessive distal myopathy caused by a biallelic mutation in UDP-N-acetylglucosamine 2-epomerase/N-acetylmannosamine kinase. In this study, we discuss the clinical features, pathological characteristics, genetic profiles, and atypical clinical manifestations of 22 Chinese GNE patients.

Materials and methods: Retrospective analysis was performed for GNE myopathy patients at our institute between 2005 and 2021. Histopathological analysis and gene testing were done according to standard protocols.

Results: Molecular analysis revealed 14-reported and 7 novel mutations, including c.125G > A (p.P42Q), c.226G > A (p.V76I), c.970C > G (p.H324D), c.155A > G (p.D52G), c.1055G > A (p.R352H), c.1064G > A (p.G355E), and c.491 T > C (p.I164T) in GNE. D207V was the most frequent mutation showing an allele frequency of 25%. A total of 21 patients presented classic clinical manifestation, and only 1 patient had signs of proximal muscle weakness. A patient containing p.V603L and p.R160X mutations showed idiopathic thrombocytopenia and distal weakness. There were 4 female patients who experienced rapid deterioration after pregnancy.

Discussion: Our study revealed 7 novel mutations in GNE, where p.D207V was shown as a potential hotspot mutation in Chinese patients. Idiopathic thrombocytopenia should be a concern in GNE myopathy patients. Twenty-seven percent of female patients experienced rapid deterioration during pregnancy or after delivery.

Keywords: Clinical presentation; Common mutations; GNE myopathy; Novel mutations.

MeSH terms

  • Distal Myopathies* / diagnosis
  • Distal Myopathies* / genetics
  • Distal Myopathies* / pathology
  • Female
  • Humans
  • Multienzyme Complexes / genetics
  • Muscle, Skeletal / pathology
  • Mutation / genetics
  • Retrospective Studies
  • Thrombocytopenia* / pathology

Substances

  • Multienzyme Complexes

Supplementary concepts

  • Distal myopathy, Nonaka type