Autosomal dominant calpainopathy due to heterozygous CAPN3 C.643_663del21

Muscle Nerve. 2018 Apr;57(4):679-683. doi: 10.1002/mus.25970. Epub 2017 Sep 30.


Introduction: A calpain-3 (CAPN3) gene heterozygous deletion (c.643_663del21) was recently linked to autosomal dominant (AD) limb-girdle muscular dystrophy. However, the possibility of digenic disease was raised. We describe 3 families with AD calpainopathy carrying this isolated mutation.

Methods: Probands heterozygous for CAPN3 c.643_663del21 were identified by targeted next generation or whole exome sequencing. Clinical findings were collected for probands and families. Calpain-3 muscle Western blots were performed in 3 unrelated individuals.

Results: Probands reported variable weakness in their 40s or 50s, with myalgia, back pain, or hyperlordosis. Pelvic girdle muscles were affected with adductor and hamstring sparing. Creatine kinase was normal to 1,800 U/L, independent of weakness severity. Imaging demonstrated lumbar paraspinal muscle atrophy. Electromyographic findings and muscle biopsies were normal to mildly myopathic. Muscle calpain-3 expression was reduced.

Discussion: This study provides further evidence for AD calpainopathy associated with CAPN3 c.643_663del21. No pathogenic variants in other genes known to cause myopathy were detected. Muscle Nerve 57: 679-683, 2018.

Keywords: CAPN3; autosomal dominant myopathy; axial myopathy; limb-girdle muscular dystrophy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Calpain / genetics*
  • Calpain / metabolism
  • Creatine Kinase / metabolism
  • DNA Mutational Analysis
  • Electromyography
  • Female
  • Heterozygote
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Male
  • Middle Aged
  • Muscle Proteins / genetics*
  • Muscle Proteins / metabolism
  • Muscle Weakness / etiology
  • Muscle Weakness / physiopathology*
  • Muscular Atrophy / diagnostic imaging*
  • Muscular Atrophy / etiology
  • Muscular Atrophy / pathology
  • Muscular Dystrophies, Limb-Girdle / complications
  • Muscular Dystrophies, Limb-Girdle / genetics*
  • Muscular Dystrophies, Limb-Girdle / metabolism
  • Muscular Dystrophies, Limb-Girdle / physiopathology
  • Mutation
  • Paraspinal Muscles / diagnostic imaging*
  • Pedigree
  • Sequence Analysis, DNA
  • Sequence Deletion


  • Muscle Proteins
  • Creatine Kinase
  • CAPN3 protein, human
  • Calpain

Supplementary concepts

  • Limb-girdle muscular dystrophy type 2A