Congenital Myopathy as a Phenotypic Expression of CACNA1S Gene Mutation: Case Report and Systematic Review of the Literature

Genes (Basel). 2023 Jun 28;14(7):1363. doi: 10.3390/genes14071363.

Abstract

Background: Congenital myopathies are a group of clinically, genetically, and histologically heterogeneous diseases caused by mutations in a large group of genes. One of these is CACNA1S, which is recognized as the cause of Dihydropyridine Receptor Congenital Myopathy.

Methods: To better characterize the phenotypic spectrum of CACNA1S myopathy, we conducted a systematic review of cases in the literature through three electronic databases following the PRISMA guidelines. We selected nine articles describing 23 patients with heterozygous, homozygous, or compound heterozygous mutations in CACNA1S and we added one patient with a compound heterozygous mutation in CACNA1S (c.1394-2A>G; c.1724T>C, p.L575P) followed at our Institute. We collected clinical and genetic data, muscle biopsies, and muscle MRIs when available.

Results: The phenotype of this myopathy is heterogeneous, ranging from more severe forms with a lethal early onset and mild-moderate forms with a better clinical course.

Conclusions: Our patient presented a phenotype compatible with the mild-moderate form, although she presented peculiar features such as a short stature, myopia, mild sensorineural hearing loss, psychiatric symptoms, and posterior-anterior impairment gradient on thigh muscle MRI.

Keywords: CACNA1S; CACNA1S myopathy; congenital myopathies; dihydropyridine receptor congenital myopathy.

Publication types

  • Systematic Review
  • Case Reports
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Calcium Channels, L-Type / genetics
  • Female
  • Humans
  • Muscle, Skeletal / pathology
  • Muscular Diseases* / genetics
  • Mutation
  • Myotonia Congenita* / genetics
  • Phenotype

Substances

  • Calcium Channels, L-Type
  • CACNA1S protein, human

Grants and funding

This work was partially supported by grant RC 2023 line 1 of Italian Ministry of Health for IRCCS Stella Maris Foundation (G.M., G.A., R.P., S.F., A.R., G.S. and R.B.).