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$Unique_ID{BRK03739}
$Pretitle{}
$Title{Fiber Type Disproportion, Congenital}
$Subject{Fiber Type Disproportion Congenital CFTD Myopathy of Congenital Fiber
Type Disproportion Atrophy of Type I Fibers Myopathy Congenital With
Fiber-Type Disproportion Batten-Turner Congenital Myopathy Becker Muscular
Dystrophy Emery-Dreifuss Muscular Dystrophy Duchenne Muscular Dystrophy
Myotonic Dystrophy Leyden-Moebius Muscular Dystrophy Gower's Muscular
Dystrophy}
$Volume{}
$Log{}

Copyright (C) 1989 National Organization for Rare Disorders, Inc.

713:
Fiber Type Disproportion, Congenital

** IMPORTANT **
It is possible that the main title of the article (Congenital Fiber Type
Disproportion) is not the name you expected.  Please check the SYNONYM
listing to find the alternate names and disorder subdivisions covered by this
article.

Synonyms

     CFTD
     Myopathy of Congenital Fiber Type Disproportion
     Atrophy of Type I Fibers
     Myopathy, Congenital, With Fiber-Type Disproportion

Information on the following diseases can be found in the Related
Disorders section of this report:

     Batten-Turner Congenital Myopathy
     Becker Muscular Dystrophy
     Emery-Dreifuss Muscular Dystrophy
     Duchenne Muscular Dystrophy
     Myotonic Dystrophy
     Leyden-Moebius Muscular Dystrophy
     Gower's Muscular Dystrophy

General Discussion

** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only.  It should not be used for diagnostic or treatment
purposes.  If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.

Congenital Fiber Type Disproportion (CFTD) is a rare genetic muscle
disease that is apparent at birth.  Major symptoms may include loss of muscle
tone (hypotonia) and weakness, scoliosis, a drawing up of the muscles, high
arched palate, dislocated hips, short stature, and deformities of the feet.

Symptoms

Congenital Fiber Type Disproportion (CFTD) is characterized by muscle
weakness which is usually noticeable at birth.  Other features may be
nonprogressive loss of muscle tone, curvature of the spine (scoliosis),
dislocation of the hip bones and foot deformities.  Some patients with CFTD
may also have involuntary movements, mental retardation, growth failure,
bulging of the forehead, and abnormal hair.  Sometimes only one feature of
the disorder is present, and in other cases many symptoms may occur.  The
only way to obtain a definite diagnosis of CFTD is by muscle biopsy which
shows a difference in the size of Type I and Type II muscle fibers:  Type I
fibers are unusually small and wasted away (atrophied).  Symptoms of this
disorder usually improve as the person gets older.

Causes

Human Traits, including the classic genetic diseases, are the product of the
interaction of two genes, one received from the father and one from the
mother.  CFTD is inherited as an autosomal recessive trait.  In recessive
disorders, the condition does not appear unless a person inherits the same
defective gene for the same trait from each parent.  If one receives one
normal gene and one gene for the disease, the person will be a carrier for
the disease, but usually will show no symptoms.  The risk of transmitting the
disease to the children of a couple, both of whom are carriers for a
recessive disorder, is twenty-five percent.  Fifty percent of their children
will be carriers, but healthy as described above.  Twenty-five percent of
their children will receive both normal genes, one from each parent, and will
be genetically normal.

Affected Population

Congenital Fiber Type Disproportion affects males and females in equal
numbers.  The disorder is usually present at birth but may improve with
advancing age.

Related Disorders

Symptoms of the following neuromuscular disorders can be similar to those of
Congenital Fiber Type Disproportion.  Comparisons may be useful for a
differential diagnosis:

Batten Turner Muscular Dystrophy first appears as muscle floppiness
during infancy.  This is followed by frequent falling and stumbling which is
associated with mild muscular weakness and generalized loss of muscle tone
(hypotonia).  There may be a slight delay on reaching milestones or early
motor development.  In particular the pelvic girdle, neck and shoulder girdle
may be affected.  Although walking usually becomes normal later in life,
there may be a residual handicap in the performance of physical activities
during adulthood.  (For more information on this disorder, choose "Batten-
Turner" as your search term in the Rare Disease Database).

Becker Muscular Dystrophy (BMD) is characterized by slowly progressive
weakness of the hip and shoulder muscles.  These muscles tend to be firm and
rubbery.  Deep tendon reflexes may be lost early in the course of this
disorder.  Ability to walk is affected, and mild mental retardation may be
present.  Joint contractures, curvature of the spine (scoliosis), restrictive
lung disease, and in rare cases heart problems, can develop with time.  (For
more information on this disorder, choose "Becker" as your search term in the
Rare Disease Database).

Emery-Dreifuss Muscular Dystrophy is usually first noticed in early
childhood, around the age of four or five, with the onset of slowly
progressive muscle weakness in the legs causing the child to walk on the
toes.  Shoulder muscles eventually show a marked weakness and walking takes
on a characteristic waddle.  Later the neck may be involved and the spine may
become rigid.  Heart problems are a very prominent feature and may result in
serious complications.  (For more information on this disorder, choose
"Emery-Dreifuss" as your search term in the Rare Disease Database).

Duchenne Muscular Dystrophy starts in infancy, but visible symptoms of
weakness generally do not appear before the age of two or three.  Neck
muscles and the large muscles of the legs and the lower trunk are the first
to be affected.  Over a period of several years, muscle wasting progresses to
the upper trunk and the arms, eventually involving all the major muscle
groups.  (For more information on this disorder, choose "Duchenne" as your
search term in the Rare Disease Database).

Myotonic Dystrophy is an inherited disorder involving the muscles,
vision, and endocrine glands.  It may also cause mental deficiency and loss
of hair.  It usually begins during young adulthood and is marked initially by
an inability to relax muscles after contraction.  Loss of muscle strength,
mental deficiency, cataracts, reduction of testicular function, and frontal
baldness are also symptomatic of this disorder.  Tripping, falling,
difficulty in moving the neck, lack of facial expression and a nasal sounding
voice are among many symptoms that can result from selective muscle
involvement.  (For more information on this disorder, choose "Myotonic" as
your search term in the Rare Disease Database).

Leyden-Moebius Muscular Dystrophy (Limb-Girdle Muscular Dystrophy) is a
progressive disorder that usually begins during pre-adolescence.  The pelvic
area is the most severely affected with weakness and muscular deterioration.
Muscles of the face, shoulders and arms are also affected.  This disorder is
inherited by a different mode of transmission than that of Becker Muscular
Dystrophy.

Gower's Muscular Dystrophy is a rare, slowly progressive weakness that
begins in the hands and feet, then extends to other nearby areas of the body
causing only moderate weakness.  This disorder usually begins during
adulthood.

Therapies:  Standard

Treatment of Congenital Fiber Type Disproportion may consist of active and
passive type exercises and physical therapy.  Functional improvement usually
occurs as the patient matures.  Genetic counseling may be of benefit for
patients and their families.  Other treatment is symptomatic and supportive.

Therapies:  Investigational

This disease entry is based upon medical information available through
December 1989.  Since NORD's resources are limited, it is not possible to keep
every entry in the Rare Disease Database completely current and accurate.
Please check with the agencies listed in the Resources section for the most
current information about this disorder.

Resources

For more information on Congenital Fiber Type Disproportion, please contact:

     National Organization for Rare Disorders (NORD)
     P.O. Box 8923
     New Fairfield, CT  06812-1783
     [phone]

     NIH/National Institute of Neurological Disorders & Stroke (NINDS)
     9000 Rockville Pike
     Bethesda, MD  20892
     [phone]
     [phone]

     Muscular Dystrophy Association, National Office
     3561 E. Sunrise Dr.
     Tucson, AZ  85718
     [phone]

For genetic information and genetic counseling referrals:

     March of Dimes Birth Defects Foundation
     1275 Mamaroneck Avenue
     White Plains, NY  10605
     [phone]

     Alliance of Genetic Support Groups
     35 Wisconsin Circle, Suite 440
     Chevy Chase, MD  20815
     (800) 336-GENE
     [phone]

References

MENDELIAN INHERITANCE IN MAN, 8th ed.:  Victor A. McKusick; Johns Hopkins
University Press, 1986.  Pp. 1094.

CLINICAL VARIABILITY IN CONGENITAL FIBER TYPE DISPROPORTION.  R.R.
Clancy, et al.; J Neurol Sci (June, 1980, issue 46 (3)).  Pp. 257-266.

CONGENITAL FIBER DISPROPORTION; ATROPHY OF TYPE I FIBERS.  REPORT OF 11
CASES.  J.A. Levy, et al.; Arq Neuropsiquiatr (June, 1987, issue 45 (2)).
Pp. 153-158.

MUSCLE FIBER TYPE TRANSFORMATION IN NEMALINE MYOPATHY AND CONGENITAL
FIBER TYPE DISPROPORTION.  T. Miike, et al.; Brain Dev (1986, issue 8 (5)).
Pp. 526-632.