Broadening the paradigm of laminin α2-related muscular dystrophy: A case of partial merosin deficiency with compound heterozygous variants

Laminin α2-related muscular dystrophy is a rare autosomal recessive condition caused by mutations in the LAMA2 gene, with clinical presentations ranging from severe congenital forms to milder phenotypes resembling limb-girdle muscular dystrophy. We report a case of a 4-month-old girl presenting with...

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Main Authors: Azita Tavasoli, Shayan Eghdami, Maryam Kachuei, Saman Rouzbeh
Format: Article
Language:English
Published: SAGE Publishing 2025-08-01
Series:SAGE Open Medical Case Reports
Online Access:https://doi.org/10.1177/2050313X251366020
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author Azita Tavasoli
Shayan Eghdami
Maryam Kachuei
Saman Rouzbeh
author_facet Azita Tavasoli
Shayan Eghdami
Maryam Kachuei
Saman Rouzbeh
author_sort Azita Tavasoli
collection DOAJ
description Laminin α2-related muscular dystrophy is a rare autosomal recessive condition caused by mutations in the LAMA2 gene, with clinical presentations ranging from severe congenital forms to milder phenotypes resembling limb-girdle muscular dystrophy. We report a case of a 4-month-old girl presenting with delayed head control, axial hypotonia, and proximal muscle weakness, while cognitive and cardiac functions remained preserved. Laboratory evaluations revealed elevated serum creatine phosphokinase and lactate dehydrogenase levels. Muscle biopsy demonstrated dystrophic changes and partial merosin deficiency. Whole-exome sequencing identified two heterozygous variants in LAMA2: a known missense variant ( c.6548T>G; p.L2183R ) and another likely pathogenic missense variant ( c.6979G>T; p.G2327 ). However, targeted parental testing and quantitative PCR confirmed c.6548T>G as paternally inherited and revealed a novel heterozygous frameshift deletion ( c.291delC ) maternally inherited, consistent with compound heterozygosity in trans. The c.6979G>T variant was not confirmed as part of the disease-causing allele combination. In silico analyses supported the pathogenicity of the novel deletion. The patient received multidisciplinary care, including individualized physical and occupational therapy, and her family received genetic counseling. This case highlights the diagnostic value of early genetic testing, the importance of confirming inheritance patterns, and the contribution of novel LAMA2 mutations to the understanding of genotype–phenotype correlations in laminin α2-related muscular dystrophy.
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spelling doaj-art-26b6dc9cc17542ba91d73c5f7ab5ef8e2025-08-25T15:04:26ZengSAGE PublishingSAGE Open Medical Case Reports2050-313X2025-08-011310.1177/2050313X251366020Broadening the paradigm of laminin α2-related muscular dystrophy: A case of partial merosin deficiency with compound heterozygous variantsAzita Tavasoli0Shayan Eghdami1Maryam Kachuei2Saman Rouzbeh3Department of Medicine, Hazrat-e Ali Asghar Hospital, Iran University of Medical Sciences, Tehran, IranBrain and Cognition Clinic, Institute for Cognitive Sciences Studies, Tehran, IranDepartment of Medicine, Hazrat-e Ali Asghar Hospital, Iran University of Medical Sciences, Tehran, IranYoung Researchers and Elite Club, Sari Branch, Islamic Azad University, Mazandaran, IranLaminin α2-related muscular dystrophy is a rare autosomal recessive condition caused by mutations in the LAMA2 gene, with clinical presentations ranging from severe congenital forms to milder phenotypes resembling limb-girdle muscular dystrophy. We report a case of a 4-month-old girl presenting with delayed head control, axial hypotonia, and proximal muscle weakness, while cognitive and cardiac functions remained preserved. Laboratory evaluations revealed elevated serum creatine phosphokinase and lactate dehydrogenase levels. Muscle biopsy demonstrated dystrophic changes and partial merosin deficiency. Whole-exome sequencing identified two heterozygous variants in LAMA2: a known missense variant ( c.6548T>G; p.L2183R ) and another likely pathogenic missense variant ( c.6979G>T; p.G2327 ). However, targeted parental testing and quantitative PCR confirmed c.6548T>G as paternally inherited and revealed a novel heterozygous frameshift deletion ( c.291delC ) maternally inherited, consistent with compound heterozygosity in trans. The c.6979G>T variant was not confirmed as part of the disease-causing allele combination. In silico analyses supported the pathogenicity of the novel deletion. The patient received multidisciplinary care, including individualized physical and occupational therapy, and her family received genetic counseling. This case highlights the diagnostic value of early genetic testing, the importance of confirming inheritance patterns, and the contribution of novel LAMA2 mutations to the understanding of genotype–phenotype correlations in laminin α2-related muscular dystrophy.https://doi.org/10.1177/2050313X251366020
spellingShingle Azita Tavasoli
Shayan Eghdami
Maryam Kachuei
Saman Rouzbeh
Broadening the paradigm of laminin α2-related muscular dystrophy: A case of partial merosin deficiency with compound heterozygous variants
SAGE Open Medical Case Reports
title Broadening the paradigm of laminin α2-related muscular dystrophy: A case of partial merosin deficiency with compound heterozygous variants
title_full Broadening the paradigm of laminin α2-related muscular dystrophy: A case of partial merosin deficiency with compound heterozygous variants
title_fullStr Broadening the paradigm of laminin α2-related muscular dystrophy: A case of partial merosin deficiency with compound heterozygous variants
title_full_unstemmed Broadening the paradigm of laminin α2-related muscular dystrophy: A case of partial merosin deficiency with compound heterozygous variants
title_short Broadening the paradigm of laminin α2-related muscular dystrophy: A case of partial merosin deficiency with compound heterozygous variants
title_sort broadening the paradigm of laminin α2 related muscular dystrophy a case of partial merosin deficiency with compound heterozygous variants
url https://doi.org/10.1177/2050313X251366020
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AT shayaneghdami broadeningtheparadigmoflaminina2relatedmusculardystrophyacaseofpartialmerosindeficiencywithcompoundheterozygousvariants
AT maryamkachuei broadeningtheparadigmoflaminina2relatedmusculardystrophyacaseofpartialmerosindeficiencywithcompoundheterozygousvariants
AT samanrouzbeh broadeningtheparadigmoflaminina2relatedmusculardystrophyacaseofpartialmerosindeficiencywithcompoundheterozygousvariants