Rare Metabolic Myopathies

Suzan İCİLa , Asburçe OLGAÇa

aAnkara Etlik City Hospital, Clinic of Pediatric Metabolism Diseases, Ankara, Türkiye

ABSTRACT
Metabolic myopathies are a series of rare congenital metabolic diseases that lead to impaired energy production. They can present with hypotonia, hypoglycemia, and encephalopathy during the neonatal and infantile period as part of multisystemic involvement, or adulthood with exercise intolerance (often with rhabdomyolysis) and weakness. Genetic causes of metabolic myopathies include mitochondrial fatty acid β-oxidation disorders, LPIN1 mutations, congenital glycogenolysis and glycolysis defects (ALDO A deficiency), and rarely mitochondrial respiratory chain disorders, peroxisomal α-methyl-acyl-CoA racemase (AMACR) deficiency, RYR1 gene mutations and Brody myopathy. Clinical findings can occur during short periods of high-intensity exercise, or catabolic situations including fasting, surgery, fever, and infections. Neurologic examination is usually inconclusive between acute events. Diagnostic methods include exercise stress testing, laboratory analyses, muscle biopsy (e.g. histology, ultrastructure, enzyme testing), and targeted (specific gene) or non-targeted (myopathy panels) genetic testing. Clinical symptoms can reduced by changing diet and lifestyle habits.
Keywords: Rare metabolic myopathies; creatine kinase; rhabdomyolysis

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