Patient with spinal muscular atrophy with respiratory distress type 1 presenting initially with hypertonia

Brain Dev. 2015 May;37(5):542-5. doi: 10.1016/j.braindev.2014.09.004. Epub 2014 Oct 1.


Spinal muscular atrophy with respiratory distress type 1 (SMARD1) is a rare autosomal recessive neuromuscular disorder caused by mutations in the IGHMBP2 gene and characterized by life-threatening respiratory distress due to irreversible diaphragmatic paralysis between 6weeks and 6months of age. In this study, we describe a two-month-old boy who presented with hypertonia at first and developed to hypotonia progressively, which was in contrast to the manifestations reported previously. Bone tissue compromise was also observed as one of the unique symptoms. Muscle biopsy indicated mild myogenic changes. He was misdiagnosed until genetic screening to be confirmed as SMARD1. SMARD1 is a clinical heterogeneous disease and this case broadens our perception of its phenotypes.

Keywords: Bone tissue compromise; Diaphragmatic paralysis; Hypertonia; IGHMBP2; Spinal muscular atrophy with respiratory distress type 1 (SMARD1).

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • DNA-Binding Proteins / genetics
  • Genetic Testing
  • Humans
  • Infant
  • Male
  • Muscle Hypertonia / diagnosis*
  • Muscle Hypertonia / genetics
  • Muscle Hypertonia / pathology
  • Muscular Atrophy, Spinal / diagnosis*
  • Muscular Atrophy, Spinal / genetics
  • Muscular Atrophy, Spinal / pathology
  • Respiratory Distress Syndrome, Newborn / diagnosis*
  • Respiratory Distress Syndrome, Newborn / genetics
  • Respiratory Distress Syndrome, Newborn / pathology
  • Respiratory Paralysis / diagnosis
  • Respiratory Paralysis / genetics
  • Respiratory Paralysis / pathology
  • Transcription Factors / genetics


  • DNA-Binding Proteins
  • IGHMBP2 protein, human
  • Transcription Factors

Supplementary concepts

  • Spinal muscular atrophy with respiratory distress 1