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Genetics Home Reference: your guide to understanding genetic conditions
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Inclusion body myopathy 2

Reviewed December 2008

What is inclusion body myopathy 2?

Inclusion body myopathy 2 is a condition that primarily affects skeletal muscles, which are muscles that the body uses for movement. This disorder causes muscle weakness that appears in late adolescence or early adulthood and worsens over time.

The first sign of inclusion body myopathy 2 is weakness of a muscle in the lower leg called the tibialis anterior. This muscle helps control up-and-down movement of the foot. Weakness in the tibialis anterior alters the way a person walks and makes it difficult to run and climb stairs. As the disorder progresses, weakness also develops in muscles of the upper legs, hips, shoulders, and hands. Unlike most forms of myopathy, inclusion body myopathy 2 usually does not affect the quadriceps, which are a group of large muscles at the front of the thigh. This condition also does not affect muscles of the eye or heart, and it does not cause neurological problems. Weakness in leg muscles makes walking increasingly difficult, and most people with inclusion body myopathy 2 require wheelchair assistance within 20 years after signs and symptoms appear.

People with the characteristic features of inclusion body myopathy 2 have been described in several different populations. When the condition was first reported in Japanese families, researchers called it distal myopathy with rimmed vacuoles (DMRV) or Nonaka myopathy. When a similar disorder was discovered in Iranian Jewish families, researchers called it rimmed vacuole myopathy or hereditary inclusion body myopathy (HIBM). It has since become clear that these conditions are variations of a single disorder caused by mutations in the same gene.

How common is inclusion body myopathy 2?

More than 200 people with inclusion body myopathy 2 have been reported. Most are of Iranian Jewish descent; the condition affects an estimated 1 in 1,500 people in this population. Additionally, at least 15 people in the Japanese population have been diagnosed with this disorder. Inclusion body myopathy 2 has also been found in several other ethnic groups worldwide.

What genes are related to inclusion body myopathy 2?

Mutations in the GNE gene cause inclusion body myopathy 2. The GNE gene provides instructions for making an enzyme found in cells and tissues throughout the body. This enzyme is involved in a chemical pathway that produces sialic acid, which is a simple sugar that attaches to the ends of more complex molecules on the surface of cells. By modifying these molecules, sialic acid influences a wide variety of cellular functions including cell movement (migration), attaching cells to one another (adhesion), signaling between cells, and inflammation.

The mutations responsible for inclusion body myopathy 2 reduce the activity of the enzyme produced from the GNE gene, which decreases the production of sialic acid. As a result, less of this simple sugar is available to attach to cell surface molecules. Researchers are working to determine how a shortage of sialic acid leads to progressive muscle weakness in people with inclusion body myopathy 2. Sialic acid is important for the normal function of many different cells and tissues, so it is unclear why the signs and symptoms of this disorder appear to be limited to the skeletal muscles.

Related Gene(s)

Changes in this gene are associated with inclusion body myopathy 2.

  • GNE

How do people inherit inclusion body myopathy 2?

This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.

Where can I find information about diagnosis or management of inclusion body myopathy 2?

These resources address the diagnosis or management of inclusion body myopathy 2 and may include treatment providers.

  • Gene Review: Inclusion Body Myopathy 2 (http://www.ncbi.nlm.nih.gov/books/NBK1262/)
  • Genetic Testing Registry: Inclusion body myopathy 2 (http://www.ncbi.nlm.nih.gov/gtr/conditions/C1833373)
  • Genetic Testing Registry: Nonaka myopathy (http://www.ncbi.nlm.nih.gov/gtr/conditions/C1853926)

You might also find information on the diagnosis or management of inclusion body myopathy 2 in Educational resources (http://www.ghr.nlm.nih.gov/condition/inclusion-body-myopathy-2/show/Educational+resources) and Patient support (http://www.ghr.nlm.nih.gov/condition/inclusion-body-myopathy-2/show/Patient+support).

General information about the diagnosis (http://ghr.nlm.nih.gov/handbook/consult/diagnosis) and management (http://ghr.nlm.nih.gov/handbook/consult/treatment) of genetic conditions is available in the Handbook. Read more about genetic testing (http://ghr.nlm.nih.gov/handbook/testing), particularly the difference between clinical tests and research tests (http://ghr.nlm.nih.gov/handbook/testing/researchtesting).

To locate a healthcare provider, see How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

Where can I find additional information about inclusion body myopathy 2?

You may find the following resources about inclusion body myopathy 2 helpful. These materials are written for the general public.

You may also be interested in these resources, which are designed for healthcare professionals and researchers.

What other names do people use for inclusion body myopathy 2?

  • Distal myopathy with rimmed vacuoles
  • DMRV
  • Hereditary inclusion body myopathy
  • HIBM
  • IBM2
  • Inclusion body myopathy, autosomal recessive
  • Inclusion body myopathy, quadriceps-sparing
  • Nonaka myopathy
  • QSM
  • Rimmed vacuole myopathy

For more information about naming genetic conditions, see the Genetics Home Reference Condition Naming Guidelines (http://ghr.nlm.nih.gov/ConditionNameGuide) and How are genetic conditions and genes named? (http://ghr.nlm.nih.gov/handbook/mutationsanddisorders/naming) in the Handbook.

What if I still have specific questions about inclusion body myopathy 2?

Ask the Genetic and Rare Diseases Information Center (http://rarediseases.info.nih.gov/GARD/).

What glossary definitions help with understanding inclusion body myopathy 2?

anterior ; autosomal ; autosomal recessive ; cell ; distal ; enzyme ; gene ; glycolipids ; glycoproteins ; hereditary ; inclusion body ; inflammation ; inherited ; neurological ; population ; recessive ; sialic acid ; sign ; simple sugar ; vacuole

You may find definitions for these and many other terms in the Genetics Home Reference Glossary (http://www.ghr.nlm.nih.gov/glossary).

References

  • Argov Z, Eisenberg I, Grabov-Nardini G, Sadeh M, Wirguin I, Soffer D, Mitrani-Rosenbaum S. Hereditary inclusion body myopathy: the Middle Eastern genetic cluster. Neurology. 2003 May 13;60(9):1519-23. (http://www.ncbi.nlm.nih.gov/pubmed/12743242?dopt=Abstract)
  • Eisenberg I, Avidan N, Potikha T, Hochner H, Chen M, Olender T, Barash M, Shemesh M, Sadeh M, Grabov-Nardini G, Shmilevich I, Friedmann A, Karpati G, Bradley WG, Baumbach L, Lancet D, Asher EB, Beckmann JS, Argov Z, Mitrani-Rosenbaum S. The UDP-N-acetylglucosamine 2-epimerase/N-acetylmannosamine kinase gene is mutated in recessive hereditary inclusion body myopathy. Nat Genet. 2001 Sep;29(1):83-7. (http://www.ncbi.nlm.nih.gov/pubmed/11528398?dopt=Abstract)
  • Gene Review: Inclusion Body Myopathy 2 (http://www.ncbi.nlm.nih.gov/books/NBK1262/)
  • Kayashima T, Matsuo H, Satoh A, Ohta T, Yoshiura K, Matsumoto N, Nakane Y, Niikawa N, Kishino T. Nonaka myopathy is caused by mutations in the UDP-N-acetylglucosamine-2-epimerase/N-acetylmannosamine kinase gene (GNE). J Hum Genet. 2002;47(2):77-9. (http://www.ncbi.nlm.nih.gov/pubmed/11916006?dopt=Abstract)
  • Malicdan MC, Noguchi S, Nishino I. Perspectives on distal myopathy with rimmed vacuoles or hereditary inclusion body myopathy: contributions from an animal model. Lack of sialic acid, a central determinant in sugar chains, causes myopathy? Acta Myol. 2007 Dec;26(3):171-5. Review. (http://www.ncbi.nlm.nih.gov/pubmed/18646567?dopt=Abstract)
  • Malicdan MC, Noguchi S, Nishino I. Recent advances in distal myopathy with rimmed vacuoles (DMRV) or hIBM: treatment perspectives. Curr Opin Neurol. 2008 Oct;21(5):596-600. doi: 10.1097/WCO.0b013e32830dd595. Review. (http://www.ncbi.nlm.nih.gov/pubmed/18769255?dopt=Abstract)
  • Mastaglia FL, Lamont PJ, Laing NG. Distal myopathies. Curr Opin Neurol. 2005 Oct;18(5):504-10. Review. (http://www.ncbi.nlm.nih.gov/pubmed/16155432?dopt=Abstract)
  • Nishino I, Malicdan MC, Murayama K, Nonaka I, Hayashi YK, Noguchi S. Molecular pathomechanism of distal myopathy with rimmed vacuoles. Acta Myol. 2005 Oct;24(2):80-3. Review. (http://www.ncbi.nlm.nih.gov/pubmed/16550921?dopt=Abstract)
  • Nishino I, Noguchi S, Murayama K, Driss A, Sugie K, Oya Y, Nagata T, Chida K, Takahashi T, Takusa Y, Ohi T, Nishimiya J, Sunohara N, Ciafaloni E, Kawai M, Aoki M, Nonaka I. Distal myopathy with rimmed vacuoles is allelic to hereditary inclusion body myopathy. Neurology. 2002 Dec 10;59(11):1689-93. (http://www.ncbi.nlm.nih.gov/pubmed/12473753?dopt=Abstract)
  • Nonaka I, Noguchi S, Nishino I. Distal myopathy with rimmed vacuoles and hereditary inclusion body myopathy. Curr Neurol Neurosci Rep. 2005 Feb;5(1):61-5. Review. (http://www.ncbi.nlm.nih.gov/pubmed/15676110?dopt=Abstract)
  • Tomimitsu H, Shimizu J, Ishikawa K, Ohkoshi N, Kanazawa I, Mizusawa H. Distal myopathy with rimmed vacuoles (DMRV): new GNE mutations and splice variant. Neurology. 2004 May 11;62(9):1607-10. (http://www.ncbi.nlm.nih.gov/pubmed/15136692?dopt=Abstract)

 

The resources on this site should not be used as a substitute for professional medical care or advice. Users seeking information about a personal genetic disease, syndrome, or condition should consult with a qualified healthcare professional. See How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

 
Reviewed: December 2008
Published: July 21, 2014