Journal
MUSCLE & NERVE
Volume 60, Issue 1, Pages 98-103Publisher
WILEY
DOI: 10.1002/mus.26486
Keywords
aCGH; GNE myopathy (HIBM); molecular diagnostics; myositis; next generation sequencing; transcriptome sequencing (RNA-seq)
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Funding
- Muscular Dystrophy Association [MDA578400, MDA418496]
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Introduction: UDP N-acetylglucosamine2-epimerase/N-acetylmannosamine-kinase (GNE) gene mutations can cause mostly autosomal-recessive myopathy with juvenile-onset known as hereditary inclusion-body myopathy (HIBM). Methods: We describe a family of a patient showing an unusual HIBM with both vacuolar myopathy and myositis without quadriceps-sparing, hindering diagnosis. We show how genetic testing with functional assays, clinical transcriptome sequencing (RNA-seq) in particular, helped facilitate both the diagnosis and a better understanding of the genotype-phenotype relationship. Results: We identified a novel 7.08 kb pathogenic deletion upstream of GNE using array comparative genomic hybridization (aCGH) and a common Val727Met variant. Using RNA-seq, we found only monoallelic (Val727Met-allele) expression, leading to similar to 50% GNE reduction in muscle. Importantly, alpha-dystroglycan is hypoglycosylated in the patient muscle, suggesting HIBM could be a dystroglycanopathy. Conclusions: Our study shows the importance of considering aCGH for GNE-myopathies, and the potential of RNA-seq for faster, definitive molecular diagnosis of unusual myopathies. Muscle Nerve, 2019
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