INTRODUCTION: Muscle magnetic resonance imaging (MRI) is a useful tool for visualizing abnormalities in neuromuscular disorders. The value of muscle MRI has not been studied in long-chain fatty acid oxidation (lcFAO) disorders. LcFAO disorders may present with metabolic myopathy including episodic rhabdomyolysis. OBJECTIVE: To investigate whether lcFAO disorders are associated with muscle MRI abnormalities. METHODS: Lower body MRI was performed in 20 patients with lcFAO disorders, i.e. three carnitine palmitoyltransferase 2 deficiency (CPT2D), 12 very long-chain acyl-CoA dehydrogenase deficiency (VLCADD), three mitochondrial trifunctional protein deficiency (MTPD) and two isolated long-chain hydroxyacyl-CoA dehydrogenase deficiency (LCHADD). RESULTS: At the time of MRI, four patients had muscle weakness, 14 had muscle pain and 13 were exercise intolerant. Median creatine kinase (CK) level of patients at the day of MRI was 398 U/L (range 35-12,483). T1W and STIR signal intensity (SI) were markedly increased in MTPD patients from girdle to lower leg. VLCADD patients showed predominantly proximal T1W SI changes, whereas LCHADD patients mostly showed distal T1W SI changes. Prominent STIR weighted signal intensity increases of almost all muscle groups were observed in patients with VLCADD and LCHADD with very high CK (>11.000) levels. CONCLUSIONS AND RELEVANCE: lcFAO disorders are associated with specific patterns of increased T1W and STIR signal intensity. These patterns may reflect lipid accumulation and inflammation secondary to lcFAO defects and progressive muscle damage. Future studies are needed to investigate whether muscle MRI might be a useful tool to monitor disease course and to study pathogenesis of lcFAO related myopathy.
INTRODUCTION: Muscle magnetic resonance imaging (MRI) is a useful tool for visualizing abnormalities in neuromuscular disorders. The value of muscle MRI has not been studied in long-chain fatty acid oxidation (lcFAO) disorders. LcFAO disorders may present with metabolic myopathy including episodic rhabdomyolysis. OBJECTIVE: To investigate whether lcFAO disorders are associated with muscle MRI abnormalities. METHODS: Lower body MRI was performed in 20 patients with lcFAO disorders, i.e. three carnitine palmitoyltransferase 2 deficiency (CPT2D), 12 very long-chain acyl-CoA dehydrogenase deficiency (VLCADD), three mitochondrial trifunctional protein deficiency (MTPD) and two isolated long-chain hydroxyacyl-CoA dehydrogenase deficiency (LCHADD). RESULTS: At the time of MRI, four patients had muscle weakness, 14 had muscle pain and 13 were exercise intolerant. Median creatine kinase (CK) level of patients at the day of MRI was 398 U/L (range 35-12,483). T1W and STIR signal intensity (SI) were markedly increased in MTPDpatients from girdle to lower leg. VLCADD patients showed predominantly proximal T1W SI changes, whereas LCHADD patients mostly showed distal T1W SI changes. Prominent STIR weighted signal intensity increases of almost all muscle groups were observed in patients with VLCADD and LCHADD with very high CK (>11.000) levels. CONCLUSIONS AND RELEVANCE: lcFAO disorders are associated with specific patterns of increased T1W and STIR signal intensity. These patterns may reflect lipid accumulation and inflammation secondary to lcFAO defects and progressive muscle damage. Future studies are needed to investigate whether muscle MRI might be a useful tool to monitor disease course and to study pathogenesis of lcFAO related myopathy.
Authors: B S Andresen; S Olpin; B J Poorthuis; H R Scholte; C Vianey-Saban; R Wanders; L Ijlst; A Morris; M Pourfarzam; K Bartlett; E R Baumgartner; J B deKlerk; L D Schroeder; T J Corydon; H Lund; V Winter; P Bross; L Bolund; N Gregersen Journal: Am J Hum Genet Date: 1999-02 Impact factor: 11.025
Authors: F Fatehi; A A Okhovat; Y Nilipour; M Mroczek; V Straub; A Töpf; A Palibrk; S Peric; V Rakocevic Stojanovic; H Najmabadi; S Nafissi Journal: Eur J Neurol Date: 2020-07-24 Impact factor: 6.089
Authors: Abbe N Vallejo; Henry J Mroczkowski; Joshua J Michel; Michael Woolford; Harry C Blair; Patricia Griffin; Elizabeth McCracken; Stephanie J Mihalik; Miguel Reyes-Mugica; Jerry Vockley Journal: Clin Transl Immunology Date: 2021-06-27
Authors: E F Diekman; G Visser; J P J Schmitz; R A J Nievelstein; M de Sain-van der Velden; M Wardrop; W L Van der Pol; S M Houten; N A W van Riel; T Takken; J A L Jeneson Journal: PLoS One Date: 2016-02-16 Impact factor: 3.240
Authors: Daniela Avila-Smirnow; Audrey Boutron; María de Los Ángeles Beytía-Reyes; Oscar Contreras-Olea; Alfredo Caicedo-Feijoo; Roger Gejman-Enríquez; Raúl Escobar-Henríquez; Jorge Förster-Mujica Journal: J Med Case Rep Date: 2018-08-28