@article{LoCascioGoetzeLatshangetal.2016,
  author    = {Lo Cascio, Christian M. and Goetze, Oliver and Latshang, Tsogyal D. and Bluemel, Sena and Frauenfelder, Thomas and Bloch, Konrad E.},
  title     = {Gastrointestinal Dysfunction in Patients with Duchenne Muscular Dystrophy},
  series = {PLoS ONE},
  volume    = {11},
  journal   = {PLoS ONE},
  number    = {10},
  doi       = {10.1371/journal.pone.0163779},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-166793},
  pages     = {e0163779},
  year      = {2016},
  abstract  = {Background In adult patients with Duchenne muscular dystrophy (DMD) life-threatening constipation has been reported. Since gastrointestinal function in DMD has not been rigorously studied we investigated objective and subjective manifestations of gastrointestinal disturbances in DMD patients. Methods In 33 patients with DMD, age 12-41 years, eating behavior and gastrointestinal symptoms were evaluated by questionnaires. Gastric emptying half time (T\(_{1/2}\)) and oro-cecal transit time (OCTT) were evaluated by analyzing \(^{13}\)CO\(_{2}\) exhalation curves after ingestion of \(^{13}\)C labeled test meals. Colonic transit time (CTT) was measured by abdominal radiography following ingestion of radiopaque markers. Results The median (quartiles) T\(_{1/2}\) was 187 (168, 220) minutes, the OCTT was 6.3 (5.0, 7.9) hours, both substantially longer than normal data (Goetze 2005, T\(_{1/2}\): 107±10; Geypens 1999, OCTT 4.3±0.1 hours). The median CTT was 60 (48, 82) hours despite extensive use of laxative measures (Meier 1995, upper limit of normal: 60 hours). T\(_{1/2}\) and OCTT did not correlate with symptoms evaluated by the Gastroparesis Cardinal Symptom Index (GCSI) (Spearman r = -0.3, p = 0.1; and r = -0.15, p = 0.4, respectively). CTT was not correlated with symptoms of constipation assessed by ROME III criteria (r = 0.12, p = 0.5). Conclusions DMD patients have a markedly disturbed gastrointestinal motor function. Since objective measures of impaired gastrointestinal transport are not correlated with symptoms of gastroparesis or constipation our findings suggest that measures assuring adequate intestinal transport should be taken independent of the patient's perception in order to prevent potentially life threatening constipation, particularly in older DMD patients.},
  language  = {en}
}
@article{ZaumNandaKressetal.2022,
  author    = {Zaum, Ann-Kathrin and Nanda, Indrajit and Kress, Wolfram and Rost, Simone},
  title     = {Detection of pericentric inversion with breakpoint in DMD by whole genome sequencing},
  series = {Molecular Genetics \& Genomic Medicine},
  volume    = {10},
  journal   = {Molecular Genetics \& Genomic Medicine},
  number    = {10},
  doi       = {10.1002/mgg3.2028},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-293940},
  year      = {2022},
  abstract  = {Background Dystrophinopathies caused by variants in the DMD gene are a well-studied muscle disease. The most common type of variant in DMD are large deletions. Very rarely reported forms of variants are chromosomal translocations, inversions and deep intronic variants (DIVs) because they are not detectable by standard diagnostic techniques (sequencing of coding sequence, copy number variant detection). This might be the reason that some clinically and histologically proven dystrophinopathy cases remain unsolved. Methods We used whole genome sequencing (WGS) to screen the entire DMD gene for variants in one of two brothers suffering from typical muscular dystrophy with strongly elevated creatine kinase levels. Results Although a pathogenic DIV could not be detected, we were able to identify a pericentric inversion with breakpoints in DMD intron 44 and Xq13.3, which could be confirmed by Sanger sequencing in the index as well as in his brother and mother. As this variation affects a major part of DMD it is most likely disease causing. Conclusion Our findings elucidate that WGS is capable of detecting large structural rearrangements and might be suitable for the genetic diagnostics of dystrophinopathies in the future. In particular, inversions might be a more frequent cause for dystrophinopathies as anticipated and should be considered in genetically unsolved dystrophinopathy cases.},
  language  = {en}
}