Abstract

Duchenne muscular dystrophy (DMD), one of the most common progressive and severely disabling neuromuscular diseases in children, can be largely attributed to the loss of function of the DMD gene on chromosome Xp21.2-p21.1. This paper describes the case of a 10-year-old boy diagnosed with DMD. Whole exome sequencing confirmed the hypothesized large partial exonic deletion of c.7310-11543_7359del (chrX:g.31792260_31803852del) spanning exon 51 and intron 50 in DMD. This large deletion was verified to be de novo by PCR, and the two breakpoints were further confirmed by Sanger sequencing and long-read whole-genome sequencing. Notably, this partial exonic deletion was the only complex variation in the deep intron regions or intron–exon junction regions in DMD. In addition, the case study demonstrates the clinical importance of using multiple molecular genetic testing methods for the diagnosis of rare diseases.

Highlights

  • Duchenne muscular dystrophy (DMD, MIM# 310200) is inherited in an X-linked recessive manner, occurring in 1/3,600 to 1/6,000 live male births (Bushby et al, 2010)

  • DMD is associated with the DMD gene (OMIM* 300377), which consists of 79 exons and is one of the largest genes

  • We identified a de novo partial exon 51 deletion in DMD in a 10-year-old boy diagnosed with DMD by using whole exome sequencing (WES), Sanger sequencing, and LR-WGS

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Summary

Introduction

Duchenne muscular dystrophy (DMD, MIM# 310200) is inherited in an X-linked recessive manner, occurring in 1/3,600 to 1/6,000 live male births (Bushby et al, 2010). DMD is associated with the DMD gene (OMIM* 300377), which consists of 79 exons and is one of the largest genes. About two-thirds of patients inherit DMD maternally, while the remaining cases are a result of de novo mutations in DMD (Lane et al, 1983). In 2018, Liu et al observed a novel mutation of c.6241_c.6290 + 1109del1159insAC using targeted next-generation sequencing (NGS). This mutation was a 1,159-bp deletion spanning the last 50 bp of exon 43 and the first 1,109 bp of

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