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Myotonic dystrophy (DM) is the most common form of myotonic myopathy, with an estimated prevalence of 1 in 7,000 people, though milder cases often go undiagnosed.

Overview

This multisystem disorder is inherited as an autosomal dominant trait and can affect various systems, including:

  • Skeletal and smooth muscle
  • Eyes
  • Heart
  • Endocrine system
  • Central nervous system

The clinical spectrum ranges from mild to very severe, categorized into three overlapping phenotypes:

  1. Mild
  2. Classic
  3. Congenital

Genetic Basis of Myotonic Dystrophy

  1. Myotonic Dystrophy Type 1 (DM1)

    • Cause: CTG trinucleotide expansion in the untranslated region of the DMPK gene (dystrophia myotonica–protein kinase) located on chromosome 19q13.3.
    • Genetic Anticipation: The length of the CTG repeat often increases significantly between generations, leading to more severe manifestations in offspring.
  2. Myotonic Dystrophy Type 2 (DM2)

    • Previously known as proximal myotonic myopathy, DM2 is much rarer and typically not observed in childhood.

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