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Ullrich congenital muscular dystrophy
Other names	Scleroatonic muscular dystrophy
Autosomal recessive pattern is the inheritance manner of this condition
Symptoms	Muscle weakness
Types	UCMD1, UCMD2
Causes	Mutations in the COL6A1, COL6A2, COL6A3, and COL12A1 gene
Diagnostic method	Physical exam, Medical history
Medication	Physical therapy, Surgery(scoliosis)

Ullrich congenital muscular dystrophy (UCMD) is a form of congenital muscular dystrophy. There are two forms: UCMD1 and UCMD2.

UCMD1 is associated with variants of type VI collagen, while UCMD2 is associated with variants of type XII collagen.

UCMD is commonly associated with contractures, joint laxity, muscle weakness and respiratory problems, though cardiac issues are not associated with this type of CMD. It is named after Otto Ullrich, who is also known for the Ullrich-Turner syndrome.

Signs and symptoms

The presentation of Ullrich congenital muscular dystrophy in an affected individual is as follows:

• Muscle weakness
• Difficulty walking (ambulation is typically lost by age 5–15 years)
• Contractures Characteristically, bilateral contractures of the proximal joints of the upper extremities (shoulder and elbows) and proximal joints of the lower extremities (hips and knees). Spine contractures in the form of progressive scoliosis occurs and occasionally contracture of neck musculature also known as torticollis.
• Joint looseness Contractures can be associated with distal joint laxity of the upper extremities (wrists and fingers) and of the lower extremities (ankle and toes).
• Fatty infiltration of muscle

Genetics

In terms of the genetics of UCMD1, there are mutations in the genes COL6A1, COL6A2, and COL6A3. This sub-type of muscular dystrophy is both autosomal recessive and autosomal dominant in nature.

COL6A1 plays an important part in maintaining the human body's integrity of various tissues. Alpha 1 subunit of type VI collagen is the encoded protein.

In terms of the genetics of UCMD2, there are mutations in the gene COL12A1, and is autosomal recessive.

Diagnosis

In terms of the diagnosis of Ullrich congenital muscular dystrophy upon inspection follicular hyperkeratosis, may be a dermatological indicator, additionally also serum creatine kinase may be mildly above normal. Other exams/methods to ascertain if the individual has Ullrich congenital muscular dystrophy are:

• MRI
• Biopsy muscle
• Genetic testing

Differential diagnosis

This includes

• Autosomal recessive myosclerosis
• Bethlem myopathy
• Ehlers–Danlos syndrome
• Emery–Dreifuss muscular dystrophy
• Limb-girdle muscular dystrophy
• RYR1-associated multiminicore disease

Phenotypes of overlap between Ullrich congenital muscular dystrophy (UCMD) and Bethlem myopathy can be assumed. In the differential diagnosis of UCDM, even in patients without finger contractures, Bethlem myopathy could be considered.

Treatment

Treatment for Ullrich congenital muscular dystrophy can consist of physical therapy and regular stretching to prevent and reduce contractures. Respiratory support may be needed at some point by the affected individual.

Though cardiac complications are not a concern in this type of CMD, in regards to respiratory issues ventilation via a tracheostomy is a possibility in some cases.

Prognosis

The prognosis of this sub-type of MD indicates that the affected individual may eventually have feeding difficulties. Surgery, at some point, might be an option for scoliosis.

Scoliosis, which is a sideways curve of the persons vertebrate, is determined by a variety of factors, including the degree (mild or severe), in which case if possible a brace might be used by the individual.

Research

In terms of possible research for Ullrich congenital muscular dystrophy one source indicates that cyclosporine A might be of benefit to individuals with this CMD type.

According to a review by Bernardi, et al., cyclosporin A (CsA) used to treat collagen VI muscular dystrophies demonstrates a normalization of mitochondrial reaction to rotenone.

See also

• Muscular dystrophy
• Congenital muscular dystrophy
• Bethlem myopathy

References

1. ^ "Orphanet: Congenital muscular dystrophy, Ullrich type". www.orpha.net. Archived from the original on 2016-06-03. Retrieved 2016-05-11.
2. ^ Reference, Genetics Home. "collagen VI-related myopathy". Genetics Home Reference. Archived from the original on 2016-05-13. Retrieved 2016-05-11.
3. ^ "Ullrich congenital muscular dystrophy | Disease | Treatment | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program". rarediseases.info.nih.gov. Archived from the original on 2016-06-10. Retrieved 2016-05-11.
4. ^ "Phenotypic Series - PS254090 – Ullrich congenital muscular dystrophy". Online Mendelian Inheritance in Man. Archived from the original on 2023-05-01. Retrieved 2023-05-01.
5. "Ullrich congenital muscular dystrophy - Conditions - GTR - NCBI". www.ncbi.nlm.nih.gov. Archived from the original on 2016-09-15. Retrieved 2016-05-11.
6. ^ Foley, A. Reghan; Mohassel, Payam; Donkervoort, Sandra; Bolduc, Véronique; Bönnemann, Carsten G. (January 31, 1993). "Collagen VI-Related Dystrophies". In Adam, Margaret P.; Ardinger, Holly H.; Pagon, Roberta A.; Wallace, Stephanie E.; Bean, Lora JH; Gripp, Karen W.; Mirzaa, Ghayda M.; Amemiya, Anne (eds.). GeneReviews®. University of Washington, Seattle. PMID 20301676. Archived from the original on August 13, 2020. Retrieved November 11, 2012.
7. Ullrich, O. (December 1930). "Kongenitale, atonisch-sklerotische Muskeldystrophie, ein weiterer Typus der heredodegenerativen Erkrankungen des neuromuskulären Systems". Zeitschrift für die gesamte Neurologie und Psychiatrie (in German). 126 (1): 171–201. doi:10.1007/BF02864097. ISSN 0303-4194.
8. ^ Bönnemann, Carsten G. (2011). "Chapter 5 - The collagen VI-related myopathies: Ullrich congenital muscular dystrophy and Bethlem myopathy". Handbook of Clinical Neurology. Vol. 101. Elsevier. pp. 81–96. doi:10.1016/B978-0-08-045031-5.00005-0. ISBN 9780080450315. PMC 5207779. PMID 21496625.
9. Bönnemann, Carsten G. (2011-06-21). "The collagen VI-related myopathies: muscle meets its matrix". Nature Reviews. Neurology. 7 (7): 379–390. doi:10.1038/nrneurol.2011.81. ISSN 1759-4758. PMC 5210181. PMID 21691338.
10. ^ El-Sobky, Tamer A.; Abdulhady, Hala; Mahmoud, Shady; Amen, John (31 January 2024). "Orthopedic manifestations of congenital muscular dystrophy subtypes in children: Emerging signatures need consolidation: a scoping review". Journal of Musculoskeletal Surgery and Research. 8: 11–23. doi:10.25259/JMSR_229_2023.
11. "COL6A1 collagen type VI alpha 1 [Homo sapiens (human)] - Gene - NCBI". www.ncbi.nlm.nih.gov. Archived from the original on 2016-08-21. Retrieved 2016-05-11.
12. Bushby, Kate M. D.; Collins, James; Hicks, Debbie (2014). "Collagen type VI myopathies". Progress in Heritable Soft Connective Tissue Diseases. Advances in Experimental Medicine and Biology. Vol. 802. pp. 185–199. doi:10.1007/978-94-007-7893-1_12. ISBN 978-94-007-7892-4. ISSN 0065-2598. PMID 24443028. Archived from the original on 2024-07-05. Retrieved 2024-07-05.
13. Reed, Umbertina Conti; Ferreira, Lucio Gobbo; Liu, Enna Cristina; Resende, Maria Bernadete Dutra; Carvalho, Mary Souza; Marie, Suely Kazue; Scaff, Milberto (September 2005). "Ullrich congenital muscular dystrophy and bethlem myopathy: clinical and genetic heterogeneity". Arquivos de Neuro-Psiquiatria. 63 (3b): 785–790. doi:10.1590/S0004-282X2005000500013. ISSN 0004-282X. PMID 16258657.
14. Emad R Noor (July 3, 2019). "Congenital Muscular Dystrophy Treatment & Management: Medical Care, Surgical Care, Consultations". Medscape. Archived from the original on 2020-11-30. Retrieved 2019-09-04.
15. "Scoliosis: MedlinePlus". www.nlm.nih.gov. Archived from the original on 2016-05-14. Retrieved 2016-05-12.
16. "OMIM Entry - # 254090 - Ullrich Congenital Muscular Dystrophy; UCMD1". omim.org. Archived from the original on 2015-12-24. Retrieved 2016-05-12.
17. Bernardi, Paolo; Bonaldo, Paolo (May 2013). "Mitochondrial Dysfunction and Defective Autophagy in the Pathogenesis of Collagen VI Muscular Dystrophies". Cold Spring Harbor Perspectives in Biology. 5 (5). a011387. doi:10.1101/cshperspect.a011387. ISSN 1943-0264. PMC 3632061. PMID 23580791.

Further reading

• Kelly, Evelyn B. (2013-01-07). Encyclopedia of Human Genetics and Disease [2 volumes]. ABC-CLIO. ISBN 9780313387142.
• Carakushansky, Gerson; Ribeiro, Marcia Gonçalves; Kahn, Evelyn (2011). "Moderately progressive Ullrich congenital muscular dystrophy". Jornal de Pediatria. 88 (1): 93–96. doi:10.2223/JPED.2112. ISSN 0021-7557. PMID 22016142.
• "National Guideline Clearinghouse | Evidence-based guideline summary: evaluation, diagnosis, and management of congenital muscular dystrophy: report of the Guideline Development Subcommittee of the American Academy of Neurology and the Practice Issues Review Panel of the American Association of Neuromuscular and Electrodiagnostic Medicine". www.guideline.gov. Archived from the original on 2016-04-08. Retrieved 2016-05-12.
• Hicks, D.; Lampe, A. K.; Laval, S. H.; Allamand, V.; Jimenez-Mallebrera, C.; Walter, M. C.; Muntoni, F.; Quijano-Roy, S.; Richard, P.; Straub, V.; Lochmuller, H.; Bushby, K. M. D. (16 November 2008). "Cyclosporine A treatment for Ullrich congenital muscular dystrophy: a cellular study of mitochondrial dysfunction and its rescue" (PDF). Brain. 132 (1): 147–155. doi:10.1093/brain/awn289. PMID 19015158. Retrieved 12 May 2016.

External links

• Myoneural junction and neuromuscular diseases
• Collagen disease
• Diseases named after discoverers
• Rare diseases