Muscle biopsy in children: Usefulness in 2012

作者：Cuisset J M^*; Maurage C A; Carpentier A; Briand G; Thevenon A; Rouaix N; Vallee L

来源：Revue Neurologique, 2013, 169(8-9): 632-639.

DOI：10.1016/j.neurol.2012.11.011

• Myopathy
• Children
• Muscle biopsy

Muscle biopsy is a mainstay diagnostic tool for investigating neuromuscular disorders in children. We report the yield of pediatric muscle biopsy in a population of 415 children by a retrospective study of 419 biopsies performed between 1/01/2000 and 31/1212009 in a neuropediatric department, including mitochondrial respiratory chain analysis for 87 children. Two hundred and fifty-five biopsies were from boys (61%) 164 from girls (39%). Their mean age at biopsy was 6.5 years; 155 (37%) biopsies were obtained before the child was 5 years old. Final histopathological diagnoses were: congenital myopathy (n = 193, including 15 structural congenital myopathies); progressive muscular dystrophy (n = 75 [18%] including 57 dystrophinopathies); congenital muscular dystrophy (n = 17, including six primary merosinopathies); dermatomyositis (n = 11); spinal muscular atrophy (n = 9, including six atypical spinal muscular atrophies); metabolic myopathy (n = 32, including 19 mitochondrial myopathies); encephalomyopathy (n = 53 [13%], including 27 with a mitochondrial respiratory chain defect). Pathological diagnosis remained undetermined in 16 cases. In 184 patients (44%), the muscle biopsy revealed specific histopathological anomalies (dystrophic process; specific ultrastructural abnormalities; perifascicular atrophy; neurogenic atrophy; metabolic anomalies) enabling a precise etiological diagnosis. For 85% of progressive muscular dystrophies, the biopsy resulted in a genetic diagnosis after identification of the protein defect. In 15% of the congenital myopathies, histopathological anomalies focused attention on one or several genes. Concerning dystrophinopathies, quantification of dystrophin deficiency on the biopsy specimen contributed to the definition of the clinical phenotype: Duchenne, or Becker. In children with a myopathy, muscle biopsy is often indispensable to establish the etiological diagnosis. Based on the results from this series, muscle biopsy can provide a precise orientation in 45% of patients, leading to a genetic hypothesis.

• 出版日期2013-9