[Inclusion Body Myopathy, Paget's Disease, and Fronto-temporal Dementia: a VCP-related Multi-systemic Proteinopathy]

Fortschr Neurol Psychiatr. 2018 Jul;86(7):434-438. doi: 10.1055/s-0044-101033. Epub 2018 Jul 20.
[Article in German]

Abstract

Mutations of the human VCP gene, which encodes the V: alosin C: ontaining P: rotein (synonyms: p97, TER ATPase), are associated with various multi-systemic protein aggregation diseases. We report on a patient with progressive myopathy and incipient cognitive deficits. A diagnostic muscle biopsy revealed an inclusion body myopathy with protein aggregates. Magnetic resonance imaging and F18-positron-emission-tomography disclosed a fronto-temporal atrophy and glucose hypometabolism of the frontal and temporal lobes, respectively. Based on the clinical findings, a genetic analysis was performed which revealed a heterozygous c.277C>T (p.Arg93Cys) mutation of the VCP gene, thus confirming the diagnosis of IBMPFD (I: nclusion B: ody M: yopathie with P: aget Disease of the Bones and F: ronto-temporal D: ementia).

Mutationen des humanen VCP-Gens, welches für das Valosin-enthaltende Protein (engl. V: alosin C: ontaining P: rotein; Synonyme: p97, TER ATPase) kodiert, sind mit verschiedenen multisystemischen Proteinaggregationserkrankungen assoziiert. Wir stellen einen Patienten vor, der an einer progressiven Myopathie und beginnenden kognitiven Defiziten leidet. In der diagnostischen Muskelbiospie zeigte sich das Bild einer Einschlusskörpermyopathie mit Proteinaggregaten. Die kraniale MRT- und F18-FDG-PET/CT Bildgebung erbrachte den Nachweis einer deutlichen fronto-temporalen Atrophie sowie einer fronto-temporalen Hypoperfusion. Basierend auf der klinischen Symptomatik des Patienten erfolgte eine molekulargenetische Diagnostik, die eine heterozygote c.277C>T (p.Arg93Cys) Mutation des VCP-Gens detektierte, so dass abschließend die Diagnose einer IBMPFD (engl. I: nclusion B: ody M: yopathie with P: aget Disease of the Bones and F: ronto-temporal D: ementia) gestellt werden konnte.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Atrophy
  • Biopsy
  • Frontotemporal Dementia / complications*
  • Frontotemporal Dementia / diagnostic imaging
  • Frontotemporal Dementia / genetics*
  • Glucose / metabolism
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Muscles / pathology
  • Muscular Dystrophies, Limb-Girdle / complications*
  • Muscular Dystrophies, Limb-Girdle / diagnostic imaging
  • Muscular Dystrophies, Limb-Girdle / genetics*
  • Mutation
  • Myositis, Inclusion Body / complications*
  • Myositis, Inclusion Body / diagnostic imaging
  • Myositis, Inclusion Body / genetics*
  • Osteitis Deformans / complications*
  • Osteitis Deformans / diagnostic imaging
  • Osteitis Deformans / genetics*
  • Positron-Emission Tomography
  • Temporal Lobe / diagnostic imaging
  • Temporal Lobe / metabolism
  • Valosin Containing Protein / genetics*

Substances

  • VCP protein, human
  • Valosin Containing Protein
  • Glucose

Supplementary concepts

  • Inclusion Body Myopathy With Early-Onset Paget Disease And Frontotemporal Dementia