Targeted screening for the detection of Pompe disease in patients with unclassified limb-girdle muscular dystrophy or asymptomatic hyperCKemia using dried blood: A Spanish cohort

Autores de IIS La Fe

• Juan Antonio Bautista Ballesteros

  Autor

• Juan Jesús Vílchez Padilla

  Autor

• Nuria Muelas Gómez

  Autor

• Isabel Illa Sendra

  Autor

• Ana Maria Martinez Arroyo

  Autor

• Montserrat Olive Plana

  Autor

• Lorena Jiménez Ramos

  Autor

Participantes ajenos a IIS La Fe

• Gutiérrez-Rivas E
• Díaz-Manera J
• Sanz I
• Arpa J
• Fernández-Torrón R
• López de Munáin A
• Solera J
• Lukacs Z

Grupos

• Patología Neuromuscular y Ataxias

Abstract

We aimed to screen for Pompe disease in patients with unclassified limb-girdle muscular dystrophy (LGMD) or asymptomatic hyperCKemia using dried blood spot (DES) assays. Subsequently, we aimed to calculate the diagnostic delay between initial symptom presentation and the diagnosis. A prospective, multicenter, observational study was conducted in 348 patients: 146 with unclassified LGMD and 202 with asymptomatic or paucisymptomatic hyperCKemia. We quantified levels of acid alpha-glucosidase (GAA) from dried blood spots analyzed fiuorometrically. The test was positive in 20 patients, and Pompe disease was confirmed by-genetic testing in 16. Undiagnosed Pompe disease was detected in 7.5% of patients with LGMD and 111 2.5% of patients with persistent, idiopathic elevation of serum creatine kinase. The c.-32-13 T > G mutation was found most commonly. The diagnostic delay was 15 years on average. In conclusion, DBS tests are useful and reliable screening tools for Pompe disease. We recommend the dried blood spot test to be included in the diagnostic work-up of patients with unclassified myopathies with proximal weakness and/or hyperCKemia of unknown cause and, when positive, to define the diagnosis, it will have to be confirmed by biochemical and/or molecular genetic analysis. (C) 2015 Elsevier B.V. All rights reserved.

Keywords

• Myopathy; Creatine kinase; Dried blood spots; Enzyme replacement therapy; Glycogen storage disease; GAA deficiency