LMOD3-Associated Nemaline Myopathy: Prenatal Ultrasonographic, Pathologic, and Molecular Findings

J Ultrasound Med. 2018 Jul;37(7):1827-1833. doi: 10.1002/jum.14520. Epub 2018 Jan 13.

Abstract

To describe the prenatal presentation, including ultrasonographic, histologic, and molecular findings, in 2 fetuses affected with LMOD3-related nemaline myopathy. Prenatal ultrasonographic examinations and histopathologic studies were performed on 2 fetuses with evidence of nemaline myopathy. To establish a molecular diagnosis, whole-exome sequencing was pursued for the affected fetuses. Nemaline myopathy is a common form of congenital myopathy manifesting with nonprogressive generalized muscle weakness, hypotonia, and electron-dense protein inclusions in skeletal myofibers. Although clinically, nemaline myopathy can be viewed as a common pathway phenotype, its molecular basis is heterogeneous, with mutations in 11 identified genes implicated in its pathogenesis so far. Whole-exome sequencing revealed that the affected fetuses were compound heterozygous for 2 newly reported pathogenic variants in the LMOD3 gene, which encodes leiomodin 3. To our knowledge, this article is the first report of LMOD3-related nemaline myopathy since the original reported cohort. We provide a detailed description of the prenatal imaging of these affected fetuses, which we hope, in combination with next-generation sequencing, may contribute to further diagnosis in additional families.

Keywords: LMOD3; arthrogryposis; genetics; leiomodin 3; nemaline myopathy; pediatrics.

Publication types

  • Case Reports

MeSH terms

  • Abortion, Eugenic
  • Adult
  • Exome Sequencing / methods
  • Female
  • Humans
  • Male
  • Microfilament Proteins
  • Muscle Proteins / genetics*
  • Muscle, Skeletal / diagnostic imaging
  • Muscle, Skeletal / pathology
  • Mutation / genetics
  • Myopathies, Nemaline / diagnostic imaging*
  • Myopathies, Nemaline / genetics*
  • Myopathies, Nemaline / pathology*
  • Pregnancy
  • Ultrasonography, Prenatal / methods*

Substances

  • LMOD3 protein, human
  • Microfilament Proteins
  • Muscle Proteins