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Miopatia nemalínica típica
ORPHA:171436CID-10 · G71.2CID-11 · 8C72.00DOENÇA RARA

A miopatia nemalínica típica (MN) é uma forma moderada da doença que aparece em recém-nascidos. Ela causa fraqueza nos músculos do rosto e do corpo, e uma dificuldade leve para respirar.

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Introdução

O que você precisa saber de cara

📋

A miopatia nemalínica típica (MN) é uma forma moderada da doença que aparece em recém-nascidos. Ela causa fraqueza nos músculos do rosto e do corpo, e uma dificuldade leve para respirar.

Publicações científicas
6 artigos
Último publicado: 2023 Oct 12

Escala de raridade

CLASSIFICAÇÃO ORPHANET · BRASIL 2024
1-9 / 100 000
Ultra-rara
<1/50k
Muito rara
1/20k
Rara
1/10k
Pouco freq.
1/5k
Incomum
1/2k
Prevalência
0.0
Europe
Início
Antenatal
+ neonatal
🏥
SUS: Cobertura mínimaScore: 15%
CID-10: G71.2
🇧🇷Dados SUS / DATASUS
PROCEDIMENTOS SIGTAP (2)
0202010694
Sequenciamento completo do exoma (WES)genetic_test
0301070040
Atendimento em reabilitação — doenças rarasrehabilitation
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Entender a doença

Do básico ao detalhe, leia no seu ritmo

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Sinais e sintomas

O que aparece no corpo e com que frequência cada sintoma acontece

Partes do corpo afetadas

💪
Músculos
38 sintomas
🦴
Ossos e articulações
12 sintomas
😀
Face
11 sintomas
🧠
Neurológico
9 sintomas
🫁
Pulmão
2 sintomas
👁️
Olhos
2 sintomas

+ 48 sintomas em outras categorias

Características mais comuns

55%prev.
Palato ogival
Frequente (79-30%)
55%prev.
Fraqueza dos dorsiflexores do pé
Frequente (79-30%)
55%prev.
Hipotonia neonatal
Frequente (79-30%)
55%prev.
Aumento da variabilidade no diâmetro da fibra muscular
Frequente (79-30%)
55%prev.
Fraqueza muscular axial
Frequente (79-30%)
55%prev.
Predominância de fibras musculares tipo 1
Frequente (79-30%)
130sintomas
Frequente (13)
Ocasional (25)
Muito raro (1)
Sem dados (91)

Os sintomas variam de pessoa para pessoa. Abaixo estão as 130 características clínicas mais associadas, ordenadas por frequência.

Palato ogivalHigh palate
Frequente (79-30%)55%
Fraqueza dos dorsiflexores do péFoot dorsiflexor weakness
Frequente (79-30%)55%
Hipotonia neonatalNeonatal hypotonia
Frequente (79-30%)55%
Aumento da variabilidade no diâmetro da fibra muscularIncreased variability in muscle fiber diameter
Frequente (79-30%)55%
Fraqueza muscular axialAxial muscle weakness
Frequente (79-30%)55%

Linha do tempo da pesquisa

Publicações por ano — veja quando o interesse científico cresceu
Anos de pesquisa3desde 2023
Total histórico6PubMed
Últimos 10 anos4publicações
Pico20151 papers
Linha do tempo
2023Hoje · 2026
Publicações por ano (últimos 10 anos)

Encontrou um erro ou informação desatualizada? Sugira uma correção →

Genética e causas

O que está alterado no DNA e como passa nas famílias

Genes associados

6 genes identificados com associação a esta condição. Padrão de herança: Autosomal dominant, Autosomal recessive.

TPM2Tropomyosin beta chainDisease-causing germline mutation(s) inTolerante
FUNÇÃO

Binds to actin filaments in muscle and non-muscle cells. Plays a central role, in association with the troponin complex, in the calcium dependent regulation of vertebrate striated muscle contraction. Smooth muscle contraction is regulated by interaction with caldesmon. In non-muscle cells is implicated in stabilizing cytoskeleton actin filaments. The non-muscle isoform may have a role in agonist-mediated receptor internalization

LOCALIZAÇÃO

Cytoplasm, cytoskeleton

VIAS BIOLÓGICAS (2)
Smooth Muscle ContractionStriated Muscle Contraction
MECANISMO DE DOENÇA

Congenital myopathy 23

An autosomal dominant muscular disorder characterized clinically by hypotonia and muscle weakness, and a static or slowly progressive clinical course. Disease onset ranges from birth to childhood. Histologic examination of muscle fibers shows various anomalies including fiber type disproportion, an irregular myofibrillar network, abnormal thread-like or rod-shaped structures, and cap-like structures which are well demarcated and peripherally located under the sarcolemma with abnormal accumulation of sarcomeric proteins.

EXPRESSÃO TECIDUAL(Ubíquo)
Artéria tibial
4226.1 TPM
Músculo esquelético
4057.1 TPM
Esôfago - Muscular
4024.0 TPM
Esôfago - Junção
3694.6 TPM
Aorta
3154.9 TPM
OUTRAS DOENÇAS (8)
congenital myopathy 23arthrogryposis, distal, type 1ASheldon-hall syndromecap myopathy
HGNC:12011UniProt:P07951
ACTA1Actin, alpha skeletal muscleDisease-causing germline mutation(s) inTolerante
FUNÇÃO

Actins are highly conserved proteins that are involved in various types of cell motility and are ubiquitously expressed in all eukaryotic cells

LOCALIZAÇÃO

Cytoplasm, cytoskeleton

VIAS BIOLÓGICAS (3)
Regulation of CDH1 FunctionFormation of the dystrophin-glycoprotein complex (DGC)Striated Muscle Contraction
MECANISMO DE DOENÇA

Congenital myopathy 2A, typical, autosomal dominant

A muscular disorder characterized by generalized muscle weakness, delayed motor milestones, hypotonia, and muscle fiber abnormalities on histologic examination. Histologic findings include abnormal thread- or rod-like structures (nemaline rods), intranuclear rods, clumped filaments, cores, or fiber-type disproportion. The spectrum of clinical phenotypes ranges from severe neonatal presentations to onset of a milder disorder in childhood.

OUTRAS DOENÇAS (12)
congenital myopathy 2b, severe infantile, autosomal recessiveprogressive scapulohumeroperoneal distal myopathycongenital myopathy 2a, typical, autosomal dominantcongenital myopathy 2c, severe infantile, autosomal dominant
HGNC:129UniProt:P68133
LMOD3Leiomodin-3Disease-causing germline mutation(s) (loss of function) inTolerante
FUNÇÃO

Essential for the organization of sarcomeric actin thin filaments in skeletal muscle (PubMed:25250574). Increases the rate of actin polymerization (PubMed:25250574)

LOCALIZAÇÃO

CytoplasmCytoplasm, myofibril, sarcomere, M lineCytoplasm, myofibril, sarcomere, A bandCytoplasm, cytoskeleton

MECANISMO DE DOENÇA

Nemaline myopathy 10

An autosomal recessive severe form of nemaline myopathy. Nemaline myopathies are muscular disorders characterized by muscle weakness of varying severity and onset, and abnormal thread-like or rod-shaped structures in muscle fibers on histologic examination. NEM10 is characterized by early-onset generalized muscle weakness and hypotonia with respiratory insufficiency and feeding difficulties. Additional features include arthrogryposis or congenital contractures, ophthalmoplegia, a history of prematurity, reduced fetal movements, and polyhydramnios. Most patients die of respiratory failure in early infancy.

EXPRESSÃO TECIDUAL(Tecido-específico)
Músculo esquelético
153.1 TPM
Coração - Ventrículo esquerdo
38.2 TPM
Coração - Átrio
20.5 TPM
Glândula salivar
2.1 TPM
Esôfago - Muscular
1.7 TPM
INTERAÇÕES PROTEICAS (4)
OUTRAS DOENÇAS (3)
nemaline myopathy 10severe congenital nemaline myopathytypical nemaline myopathy
HGNC:6649UniProt:Q0VAK6
NEBNebulinDisease-causing germline mutation(s) inRestrito
FUNÇÃO

This giant muscle protein may be involved in maintaining the structural integrity of sarcomeres and the membrane system associated with the myofibrils. Binds and stabilize F-actin

LOCALIZAÇÃO

Cytoplasm, myofibril, sarcomereCytoplasm, cytoskeleton

VIAS BIOLÓGICAS (1)
Striated Muscle Contraction
MECANISMO DE DOENÇA

Nemaline myopathy 2

A form of nemaline myopathy. Nemaline myopathies are muscular disorders characterized by muscle weakness of varying severity and onset, and abnormal thread-like or rod-shaped structures in muscle fibers on histologic examination.

EXPRESSÃO TECIDUAL(Tecido-específico)
Músculo esquelético
846.4 TPM
Coração - Átrio
4.5 TPM
Glândula salivar
1.5 TPM
Skin Not Sun Exposed Suprapubic
1.1 TPM
Skin Sun Exposed Lower leg
1.1 TPM
OUTRAS DOENÇAS (9)
arthrogryposis multiplex congenita 6nemaline myopathynemaline myopathy 2typical nemaline myopathy
HGNC:7720UniProt:P20929
KLHL41Kelch-like protein 41Disease-causing germline mutation(s) (loss of function) inTolerante
FUNÇÃO

Involved in skeletal muscle development and differentiation. Regulates proliferation and differentiation of myoblasts and plays a role in myofibril assembly by promoting lateral fusion of adjacent thin fibrils into mature, wide myofibrils. Required for pseudopod elongation in transformed cells

LOCALIZAÇÃO

CytoplasmCytoplasm, cytoskeletonCell projection, pseudopodiumCell projection, ruffleCytoplasm, myofibril, sarcomere, M lineSarcoplasmic reticulum membraneEndoplasmic reticulum membrane

VIAS BIOLÓGICAS (2)
Antigen processing: Ubiquitination & Proteasome degradationNeddylation
MECANISMO DE DOENÇA

Nemaline myopathy 9

An autosomal recessive form of nemaline myopathy. Nemaline myopathies are muscular disorders characterized by muscle weakness of varying severity and onset, and abnormal thread-like or rod-shaped structures in muscle fibers on histologic examination. NEM9 phenotype is highly variable, ranging from death in infancy due to lack of antigravity movements, to slowly progressive distal muscle weakness with preserved ambulation later in childhood.

EXPRESSÃO TECIDUAL(Ubíquo)
Músculo esquelético
3420.3 TPM
Coração - Ventrículo esquerdo
56.8 TPM
Coração - Átrio
47.7 TPM
Pituitária
10.6 TPM
Testículo
10.3 TPM
OUTRAS DOENÇAS (5)
nemaline myopathy 9severe congenital nemaline myopathytypical nemaline myopathychildhood-onset nemaline myopathy
HGNC:16905UniProt:O60662
CFL2Cofilin-2Disease-causing germline mutation(s) inTolerante
FUNÇÃO

Controls reversibly actin polymerization and depolymerization in a pH-sensitive manner. Its F-actin depolymerization activity is regulated by association with CSPR3 (PubMed:19752190). It has the ability to bind G- and F-actin in a 1:1 ratio of cofilin to actin. It is the major component of intranuclear and cytoplasmic actin rods. Required for muscle maintenance. May play a role during the exchange of alpha-actin forms during the early postnatal remodeling of the sarcomere (By similarity)

LOCALIZAÇÃO

Nucleus matrixCytoplasm, cytoskeleton

MECANISMO DE DOENÇA

Nemaline myopathy 7

A form of nemaline myopathy. Nemaline myopathies are muscular disorders characterized by muscle weakness of varying severity and onset, and abnormal thread-like or rod-shaped structures in muscle fibers on histologic examination. Nemaline myopathy type 7 presents at birth with hypotonia and generalized weakness. Major motor milestones are delayed, but independent ambulation is achieved.

OUTRAS DOENÇAS (2)
nemaline myopathy 7typical nemaline myopathy
HGNC:1875UniProt:Q9Y281

Variantes genéticas (ClinVar)

545 variantes patogênicas registradas no ClinVar.

🧬 TPM2: GRCh38/hg38 9p24.3-q21.13(chr9:208455-72054336)x3 ()
🧬 TPM2: GRCh38/hg38 9p24.3-13.1(chr9:208455-38787483)x3 ()
🧬 TPM2: NM_003289.4(TPM2):c.563+1G>T ()
🧬 TPM2: NM_003289.4(TPM2):c.478C>T (p.Arg160Cys) ()
🧬 TPM2: NM_003289.4(TPM2):c.674T>C (p.Ile225Thr) ()
Ver todas no ClinVar

Diagnóstico

Os sinais que médicos procuram e os exames que confirmam

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Tratamento e manejo

Remédios, cuidados de apoio e o que precisa acompanhar

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Onde tratar no SUS

Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)

🇧🇷 Atendimento SUS — Miopatia nemalínica típica

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Dados de DATASUS/CNES, SBGM, ABNeuro e Ministério da Saúde. Sempre confirme a disponibilidade diretamente com o estabelecimento.

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Ensaios clínicos abertos e novidades científicas recentes

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Publicações mais relevantes

Timeline de publicações
4 papers (10 anos)
#1

Pharmacological Inhibition of Myostatin in a Mouse Model of Typical Nemaline Myopathy Increases Muscle Size and Force.

International journal of molecular sciences2023 Oct 12

Nemaline myopathy is one of the most common non-dystrophic congenital myopathies. Individuals affected by this condition experience muscle weakness and muscle smallness, often requiring supportive measures like wheelchairs or respiratory support. A significant proportion of patients, approximately one-third, exhibit compound heterozygous nebulin mutations, which usually give rise to the typical form of the disease. Currently, there are no approved treatments available for nemaline myopathy. Our research explored the modulation of myostatin, a negative regulator of muscle mass, in combating the muscle smallness associated with the disease. To investigate the effect of myostatin inhibition, we employed a mouse model with compound heterozygous nebulin mutations that mimic the typical form of the disease. The mice were treated with mRK35, a myostatin antibody, through weekly intraperitoneal injections of 10 mg/kg mRK35, commencing at two weeks of age and continuing until the mice reached four months of age. The treatment resulted in an increase in body weight and an approximate 20% muscle weight gain across most skeletal muscles, without affecting the heart. The minimum Feret diameter of type IIA and IIB fibers exhibited an increase in compound heterozygous mice, while only type IIB fibers demonstrated an increase in wild-type mice. In vitro mechanical experiments conducted on intact extensor digitorum longus muscle revealed that mRK35 augmented the physiological cross-sectional area of muscle fibers and enhanced absolute tetanic force in both wild-type and compound heterozygous mice. Furthermore, mRK35 administration improved grip strength in treated mice. Collectively, these findings indicate that inhibiting myostatin can mitigate the muscle deficits in nebulin-based typical nemaline myopathy, potentially serving as a much-needed therapeutic option.

#2

Generation of two isogenic induced pluripotent stem cell lines from a 10-year-old typical nemaline myopathy patient with a heterozygous dominant c.541G>A (p.Asp179Asn) pathogenic variant in the ACTA1 gene.

Stem cell research2021 Aug

Nemaline myopathy (NM) is a congenital myopathy typically characterized by skeletal muscle weakness and the presence of nemaline bodies in myofibres. Approximately 25% of NM cases are caused by variants in ACTA1. We generated two induced pluripotent stem cell lines from lymphoblastoid cells of a 10-year-old female with typical NM harbouring a dominant pathogenic variant in ACTA1 (c.541C>A). The isogenic lines displayed typical iPSC morphology, expressed pluripotency markers, and could differentiate into each of the three germ layers. Although the lines have partial or complete X chromosome duplication, they may still prove useful as models of human ACTA1 disease.

#3

Triggering typical nemaline myopathy with compound heterozygous nebulin mutations reveals myofilament structural changes as pathomechanism.

Nature communications2020 Jun 01

Nebulin is a giant protein that winds around the actin filaments in the skeletal muscle sarcomere. Compound-heterozygous mutations in the nebulin gene (NEB) cause typical nemaline myopathy (NM), a muscle disorder characterized by muscle weakness with limited treatment options. We created a mouse model with a missense mutation p.Ser6366Ile and a deletion of NEB exon 55, the Compound-Het model that resembles typical NM. We show that Compound-Het mice are growth-retarded and have muscle weakness. Muscles have a reduced myofibrillar fractional-area and sarcomeres are disorganized, contain rod bodies, and have longer thin filaments. In contrast to nebulin-based severe NM where haplo-insufficiency is the disease driver, Compound-Het mice express normal amounts of nebulin. X-ray diffraction revealed that the actin filament is twisted with a larger radius, that tropomyosin and troponin behavior is altered, and that the myofilament spacing is increased. The unique disease mechanism of nebulin-based typical NM reveals novel therapeutic targets.

#4

Sudden cardiac arrest in a child with nemaline myopathy.

Italian journal of pediatrics2015 Mar 21

Nemaline myopathy is a rare, non progressive congenital skeletal muscle disorder defined by the presence of inclusions known as nemaline rods in muscle fibers. Several clinical subtypes have been described, according to degree of muscle weakness, severity and age at onset. The course of nemaline myopathy is very slowly progressive, and death is usually due to respiratory failure. Cardiac involvement is rare and generally considered to be the result of ACTA1 mutations. We report the case of a 6 year old boy with typical congenital nemaline myopathy. Nemaline myopathy was confirmed at 3 years of age by muscle biopsy. No mutation of ACTA1, TPM2 and TNNT1 genes was detected. The child died suddenly of cardiac arrest and associated hypoxic-ischemic brain injury, in absence of acute respiratory failure or swallowing difficulties. Nemaline cardiomyopathy was suspected, but post mortem cardiac biopsy did not show findings consistent with nemaline myopathy. Congenital typical nemaline myopathy is not necessarily a static or very slowly progressive disorder and acute cardiac deterioration can lead to early death.

Publicações recentes

Ver todas no PubMed

Associações

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Comunidades

Grupos ativos de quem convive com esta doença aqui no Raras

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Doenças relacionadas

Doenças com sintomas parecidos — ajudam quem ainda está buscando diagnóstico

Ordenadas pelo número de sintomas em comum.

Referências e fontes

Bases de dados externas citadas neste artigo

Publicações científicas

Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.

  1. Pharmacological Inhibition of Myostatin in a Mouse Model of Typical Nemaline Myopathy Increases Muscle Size and Force.
    International journal of molecular sciences· 2023· PMID 37894805mais citado
  2. Generation of two isogenic induced pluripotent stem cell lines from a 10-year-old typical nemaline myopathy patient with a heterozygous dominant c.541G&gt;A (p.Asp179Asn) pathogenic variant in the ACTA1 gene.
    Stem cell research· 2021· PMID 34388489mais citado
  3. Triggering typical nemaline myopathy with compound heterozygous nebulin mutations reveals myofilament structural changes as pathomechanism.
    Nature communications· 2020· PMID 32483185mais citado
  4. Sudden cardiac arrest in a child with nemaline myopathy.
    Italian journal of pediatrics· 2015· PMID 25888334mais citado
  5. The exon 55 deletion in the nebulin gene--one single founder mutation with world-wide occurrence.
    Neuromuscul Disord· 2009· PMID 19232495recente

Bases de dados e fontes oficiais

Identificadores e referências canônicas usadas para montar este verbete.

  1. ORPHA:171436(Orphanet)
  2. MONDO:0015737(MONDO)
  3. GARD:12822(GARD (NIH))
  4. Variantes catalogadas(ClinVar)
  5. Busca completa no PubMed(PubMed)
  6. Q56013755(Wikidata)

Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.

Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar

Miopatia nemalínica típica
Compêndio · Raras BR

Miopatia nemalínica típica

ORPHA:171436 · MONDO:0015737
Prevalência
1-9 / 100 000
Herança
Autosomal dominant, Autosomal recessive
CID-10
G71.2 · Miopatias congênitas
CID-11
Início
Antenatal, Neonatal
Prevalência
0.0 (Europe)
MedGen
UMLS
C5680453
EuropePMC
Wikidata
Papers 10a
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