Restrictive lung involvement in facioscapulohumeral muscular dystrophy

Muscle Nerve. 2014 Nov;50(5):739-43. doi: 10.1002/mus.24218. Epub 2014 Sep 29.

Abstract

Introduction: Few studies have evaluated the frequency or predisposing factors for respiratory involvement in facioscapulohumeral muscular dystrophy type 1 (FSHD1) and type 2 (FSHD2).

Methods: We performed a prospective cross-sectional observational study of 61 genetically confirmed FSHD participants (53 FSHD1 and 8 FSHD2). Participants underwent bedside pulmonary function testing in sitting and supine positions, a standard clinical history and physical assessment, and manual muscle testing.

Results: Restrictive respiratory involvement was suggested in 9.8% (95% confidence interval 2.4-17.3): 7.5% FSHD1 and 25.0% FSHD2 (P = 0.17). Participants with testing suggestive of restrictive lung involvement (n = 6) were more severely affected (P = 0.005), had weaker hip flexion (P = 0.0007), and were more likely to use a wheelchair (P = 0.01).

Conclusions: Restrictive respiratory involvement should be considered in all moderate to severely affected FSHD patients with proximal lower extremity weakness. The higher frequency of restrictive lung disease in FSHD2 seen here requires confirmation in a larger cohort of FSHD2 patients.

Keywords: FSHD1; FSHD2; muscle disease; prevalence studies; respiratory disease.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Female
  • Humans
  • Lung Diseases / diagnosis
  • Lung Diseases / etiology*
  • Male
  • Middle Aged
  • Muscle Strength / physiology
  • Muscular Dystrophy, Facioscapulohumeral / classification
  • Muscular Dystrophy, Facioscapulohumeral / complications*
  • Muscular Dystrophy, Facioscapulohumeral / genetics
  • Prospective Studies
  • Severity of Illness Index
  • Vital Capacity / physiology