Affiliations: [a] Department of Clinical and Experimental Medicine, Neurological Clinic, University of Pisa, Pisa, Italy
| [b] Department of Surgical Pathology, Medical, Molecular, and Critical Area, University of Pisa, Pisa, Italy
| [c] Molecular Genetics, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
| [d] CNR Institute of Molecular Genetics “Luigi-Luca Cavalli-Sforza” Unit of Bologna, Bologna, Italy
| [e] IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| [f] Department of Biomedical and Neuromotor Science, ALMA MATER, University of Bologna, Italy
| [g] U.O.C. Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
Correspondence to: Giulia Ricci, Department of Clinical and Experimental Medicine, Neurological Institute, University of Pisa, Italy. Tel.: +39050993212; Fax: +39050992569; E-mail: [email protected].
Abstract: Background:Proximal muscle weakness may be the presenting clinical feature of different types of myopathies, including limb girdle muscular dystrophy and primary mitochondrial myopathy. LGMD1B is caused by LMNA mutation. It is characterized by progressive weakness and wasting leading to proximal weakness, cardiomyopathy, and hearth conduction block. Objective:In this article, we describe the case of a patient who presented with limb-girdle weakness and a double trouble scenario –mitochondrial DNA single deletion and a new LMNA mutation. Methods:Pathophysiological aspects were investigated with muscle biopsy, Western Blot analysis, NGS nuclear and mtDNA analysis and neuromuscular imaging (muscle and cardiac MRI). Results:Although secondary mitochondrial involvement is possible, a “double trouble” syndrome can not be excluded. Conclusion:Implication deriving from hypothetical coexistence of two different pathological conditions or the possible secondary mitochondrial involvement are discussed.