Centronuclear myopathy and type-1 hypotrophy without central nuclei. Distinct nosologic entities?
W. D. Lo, R. J. Barohn, R. J. Bobulski, J. Kean and J. R. Mendell
Department of Pediatrics, Ohio State University, Columbus.
Four infants presented with severe hypotonia, weakness, and hypoventilation
or apnea at birth. Their clinical presentations and courses resembled those
of the x-linked recessive form of centronuclear myopathy. Histologic
examination of their muscle biopsy specimens showed patterns ranging
between centronuclear myopathy and type-1 hypotrophy without central
nuclei. Regardless of their gender or the appearance of their biopsy
specimens, the children all had a poor outcome. The clinical and biopsy
findings in these infants suggest that centronuclear myopathy and type-1
hypotrophy without central nuclei do not represent distinct nosologic
entities. It seems more likely that the histologic changes represent
abnormalities in fiber size distribution and development, which are
nonspecific and which reflect a primary defect at one or more sites in the
neuraxis.