Beyond cervical lipomas: myoclonus, gait disorder and multisystem involvement leading to mitochondrial disease

BMJ Case Rep. 2017 Jun 19:2017:bcr2016218861. doi: 10.1136/bcr-2016-218861.

Abstract

Madelung's disease (benign symmetric lipomatosis) is a rare syndrome in which there are multiple lipomas around the neck, upper limbs and trunk in the context of chronic alcoholism. We report on a female patient with lipomas and slightly progressive myoclonus, neuropathy, myopathy, ataxia and respiratory systemic involvement (labelled in the past as Madelung's disease). Multisystem involvement and family history of lipomas led to the development of mitochondrial genetic tests, which can assess two concurrent mitochondrial mutations: the m.8344A>G mutation in MT-TK gene, related MERRF (myoclonic epilepsy with ragged-red fibre) phenotype and m.14484T>C mutation in the MT-ND6 gene responsible for Leber hereditary optic neuropathy phenotype.

Keywords: Movement disorders (other than Parkinsons); Neuro genetics; Neuromuscular disease; Visual pathway.

Publication types

  • Case Reports

MeSH terms

  • Ataxia / diagnosis
  • Female
  • Gait / physiology
  • Humans
  • Lipoma / pathology*
  • Lipomatosis, Multiple Symmetrical / diagnosis
  • Lipomatosis, Multiple Symmetrical / genetics
  • Lipomatosis, Multiple Symmetrical / pathology*
  • MERRF Syndrome / genetics
  • Middle Aged
  • Mitochondria / genetics*
  • Mitochondrial Diseases / complications
  • Mitochondrial Diseases / diagnosis*
  • Mitochondrial Diseases / genetics
  • Movement Disorders / diagnosis
  • Movement Disorders / etiology
  • Mutation
  • Myoclonus / diagnosis*
  • Myoclonus / drug therapy
  • Myoclonus / etiology
  • NADH Dehydrogenase / genetics
  • Neck / pathology*
  • Outcome Assessment, Health Care
  • Phenotype
  • Rare Diseases

Substances

  • MT-ND6 protein, human
  • NADH Dehydrogenase