Clinical features and a mutation with late onset of limb girdle muscular dystrophy 2B

J Neurol Neurosurg Psychiatry. 2013 Apr;84(4):433-40. doi: 10.1136/jnnp-2011-301339. Epub 2012 Dec 15.


Objective and methods: Dysferlin encoded by DYSF deficiency leads to two main phenotypes, limb girdle muscular dystrophy (LGMD) 2B and Miyoshi myopathy. To reveal in detail the mutational and clinical features of LGMD2B in Japan, we observed 40 Japanese patients in 36 families with LGMD2B in whom dysferlin mutations were confirmed.

Results and conclusions: Three mutations (c.1566C>G, c.2997G>T and c.4497delT) were relatively more prevalent. The c.2997G>T mutation was associated with late onset, proximal dominant forms of dysferlinopathy, a high probability that muscle weakness started in an upper limb and lower serum creatine kinase (CK) levels. The clinical features of LGMD2B are as follows: (1) onset in the late teens or early adulthood, except patients homozygous for the c.2997G>T mutation; (2) lower limb weakness at onset; (3) distal change of lower limbs on muscle CT at an early stage; (4) impairment of lumbar erector spinal muscles on muscle CT at an early stage; (5) predominant involvement of proximal upper limbs; (6) preservation of function of the hands at late stage; (7) preservation of strength in neck muscles at late stage; (8) lack of facial weakness or dysphagia; (9) avoidance of scoliosis; (10) hyper-Ckaemia; (11) preservation of cardiac function; and (12) a tendency for respiratory function to decline with disease duration. It is important that the late onset phenotype is found with prevalent mutations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Asian People
  • Creatine Kinase / blood
  • Dysferlin
  • Female
  • Heart Function Tests
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Membrane Proteins / genetics*
  • Middle Aged
  • Muscle Proteins / genetics*
  • Muscle Weakness / etiology
  • Muscle Weakness / physiopathology
  • Muscle, Skeletal / diagnostic imaging
  • Muscle, Skeletal / physiopathology
  • Muscular Dystrophies, Limb-Girdle / diagnostic imaging
  • Muscular Dystrophies, Limb-Girdle / genetics*
  • Muscular Dystrophies, Limb-Girdle / physiopathology*
  • Mutation / genetics*
  • Mutation / physiology*
  • Respiratory Function Tests
  • Retrospective Studies
  • Survival Analysis
  • Tomography, X-Ray Computed
  • Young Adult


  • DYSF protein, human
  • Dysferlin
  • Membrane Proteins
  • Muscle Proteins
  • Creatine Kinase