Distal myopathies


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 Inclusion criteria:

  • Unexplained predominantly distal muscle weakness, onset at any age
  • Acquired myopathies excluded by relevant clinical investigations
  • Serum creatine kinase (CK) assessment
  • Muscle Biopsy with immunohistochemistry (IH)
  • Neurophysiology performed
  • Muscle MRI (optional)
  • Dried blood spot test for Pompe disease performed

 Exclusion criteria:

Prior genetic testing guidance 

  • Results should have been reviewed for all genetic tests undertaken, including disease-relevant genes in exome sequencing data. The patient is not eligible if they have a molecular diagnosis for their condition.
  • Genetic testing should continue according to routine local practice for this phenotype regardless of recruitment to the project; results of these tests must be submitted via the ‘Genetic investigations’ section of the data capture tool to allow comparison of WGS with current standard testing.

PLEASE NOTE: The sensitivity of WGS compared to current diagnostic genetic testing has not yet been established. It is therefore important that tests which are clinically indicated under local standard practice continue to be carried out.

Prior genetic testing genes

Testing of the following genes should be carried out PRIOR TO RECRUITMENT where this is in line with current local practice:

  • DMD analysis by MLPA or equivalent
  • DUX1 and DMPK exclusion by conventional genetic testing
  • Exclusion by genetic testing of any gene indicated by IH.
  • In the presence of evidence of myofibrillar myopathy on muscle biopsy IH exclusion of LDB3, MYOT, DES, CRYAB by sequencing

Closing statement

These requirements will be kept under continual review during the main programme and may be subject to change

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