Entry - #181400 - SCAPULOPERONEAL SYNDROME, NEUROGENIC, KAESER TYPE; SCPNK - OMIM
# 181400

SCAPULOPERONEAL SYNDROME, NEUROGENIC, KAESER TYPE; SCPNK


Alternative titles; symbols

KAESER SYNDROME
STARK-KAESER SYNDROME
SCAPULOPERONEAL SYNDROME, NEUROGENIC TYPE, OF KAESER


Phenotype-Gene Relationships

Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
Gene/Locus Gene/Locus
MIM number
2q35 Scapuloperoneal syndrome, neurogenic, Kaeser type 181400 AD 3 DES 125660
Clinical Synopsis
 

Neuro
- Neurogenic scapuloperoneal syndrome
- Bilateral foot drop
- Late bulbar involvement
Muscle
- Peroneal atrophy
- Shoulder girdle atrophy
Limbs
- Talipes equinovarus
Inheritance
- Autosomal dominant

TEXT

A number sign (#) is used with this entry because of evidence that Kaiser-type neurogenic scapuloperoneal syndrome (SCPNK) is caused by heterozygous mutation in the DES gene (125660) on chromosome 2q35.


Clinical Features

Peroneal atrophy is accompanied by bilateral foot drop and talipes equinovarus. Following atrophy of the lower legs, the shoulder girdle is involved. Bulbar involvement is late. Autopsy shows muscular atrophy and involvement of caudal cranial nuclei. Palmer (1932) described a family with 8 persons affected, the earliest having onset about 1800. Davidenkow (1939) suggested that cases reported by Wohlfart (see juvenile muscular atrophy, 253400 and 158600) were the same as those he designated scapuloperoneal amyotrophy.

Kaeser (1965) reported a kindred (kindred F) in which 12 members in 5 generations had neurogenic scapuloperoneal syndrome in an autosomal dominant pattern of inheritance. Age at onset was between 30 and 50 years and followed a slowly progressive course. In the first 3 generations, weakness and atrophy started in the legs and spread to the thighs and pelvic girdle, resulting in paraplegia. In the fifth generation, the atrophies extended to the shoulder girdle, upper arms, neck, face, pharynx, and external eye muscles. Histologic examination at autopsy in 1 patient showed that the atrophies were neurogenic in origin, similar to those in Wohlfart-Kugelberg-Welander muscular atrophy. Kindred F, however, demonstrated significant differences from the cases reported by Davidenkow (1939) and from Wohlfart-Kugelberg-Welander juvenile muscular atrophy. Kaeser (1965) concluded that the scapuloperoneal syndrome is a descriptive term comprising various myopathies, peroneal muscular atrophies, and spinal muscular atrophies.

Emery et al. (1968) and Schuchmann (1970) reported sporadic childhood cases with electromyographic and biopsy evidence of neurogenic disease; motor nerve conduction velocities were borderline or normal, suggesting anterior horn cell pathology. Kazakov et al. (1976) provided a follow-up on the kindred reported by Davidenkow (1939). The disorder in many ways resembled Landouzy-Dejerine facioscapulohumeral muscular dystrophy (158900). There are both myopathic (see 608358) and neurogenic dominant forms of the scapuloperoneal syndrome. Emery (1981) described a large kindred in the West of Scotland. Ferguson-Smith and McKusick (1981) saw a brother and sister who clearly had this disorder. The sister had been diagnosed as having Charcot-Marie-Tooth disease and the brother muscular dystrophy. Their disease was neurogenic scapuloperoneal syndrome.

Tawil et al. (1995) described a 3-generation kindred in which 7 members were affected with neurogenic scapuloperoneal syndrome in which nerve conduction velocities showed evidence of a mild demyelinating polyneuropathy and electromyography demonstrated acute and chronic denervation in both proximal and distal muscles. The proband fulfilled the diagnostic criteria for facioscapulohumeral dystrophy (158900), but none of the other affected members had facial weakness. Linkage to markers on 4q35 was excluded, demonstrating this to be a genetically distinct disorder.

Walter et al. (2007) studied the large, multigenerational kindred first described by Kaeser (1964, 1965) with a peculiar scapuloperoneal distribution of weakness and atrophy, inherited in an autosomal dominant fashion, named scapuloperoneal syndrome type Kaeser. A large clinical variability was recognized, even within the same family, ranging from scapuloperoneal (n = 2, 12%), limb-girdle (n = 10, 60%), and distal phenotypes (n = 3, 18%) with variable cardiac (n = 7, 41%) or respiratory involvement (n = 7, 41%). Facial weakness, dysphagia, and gynecomastia were frequent additional symptoms. Affected men seemingly carried a higher risk of sudden, cardiac death as compared to affected women. Histologic and immunohistochemical examination of muscle biopsy specimens revealed a wide spectrum of findings ranging from near normal or unspecific pathology to typical, mild fibrillar changes with accumulation of desmin.


Inheritance

The transmission pattern of SCPNK in the families studied by Walter et al. (2007), including the family reported by Kaeser (1964, 1965), was consistent with autosomal dominant inheritance.


Molecular Genetics

By genetic analysis of the original kindred described by Kaeser (1964), Walter et al. (2007) found possible linkage to the gene encoding desmin and identified a heterozygous missense mutation of the desmin gene (R350P; 125660.0016) cosegregating with the disorder. Moreover, Walter et al. (2007) found the R350P mutation in 4 unrelated German families, which allowed for genotype-phenotype correlations in a total of 15 patients carrying the same mutation. This study suggested that the clinical and pathologic variability generally observed in desminopathies may not be attributed to the nature of the DES mutation alone, but may be influenced by additional genetic and epigenetic factors such as gender. Walter et al. (2007) suggested that mutations of the desmin gene should be considered early in the diagnostic workup of any adult-onset, autosomal dominant myopathy, even if specific myofibrillar pathology is absent.


REFERENCES

  1. Davidenkow, S. Scapuloperoneal amyotrophy. Arch. Neurol. Psychiat. 41: 694-701, 1939.

  2. Emery, A. E. H. Personal Communication. Edinburgh, Scotland 7/9/1981.

  3. Emery, E. S., Fenichel, G. M., Eng, G. A spinal muscular atrophy with scapuloperoneal distribution. Arch. Neurol. 18: 129-133, 1968. [PubMed: 5636068, related citations] [Full Text]

  4. Ferguson-Smith, M. A., McKusick, V. A. Personal Communication. Glasgow, Scotland and Baltimore, Md. 7/9/1981.

  5. Gharbi Ben Ayed, A., Samoud, A., Ben Dridi, M. F. Amyotrophie scapulo-peroniere d'origine neurogene type Stark-Kaeser: etude d'une observation familiale. Arch. Franc. Pediat. 50: 135-137, 1993. [PubMed: 8343020, related citations]

  6. Kaeser, H. E. Die familiaere scapuloperoneale Muskelatrophie. Dtsch. Z. Nervenheilkd. 186: 379-394, 1964. [PubMed: 14326018, related citations]

  7. Kaeser, H. E. Scapuloperoneal muscular atrophy. Brain 88: 407-418, 1965. [PubMed: 5828910, related citations] [Full Text]

  8. Kazakov, V. M., Bogorodinsky, D. K., Skorometz, A. A. The myogenic scapulo-peroneal syndrome. Muscular dystrophy in the K. kindred: clinical study and genetics. Clin. Genet. 10: 41-50, 1976. [PubMed: 949863, related citations] [Full Text]

  9. Palmer, H. D. Familial scapuloperoneal amyotrophy. Arch. Neurol. Psychiat. 28: 473-477, 1932.

  10. Ricker, K., Mertens, H. G., Schimrigk, K. The neurogenic scapuloperoneal syndrome. Europ. Neurol. 1: 257-274, 1968. [PubMed: 5696601, related citations] [Full Text]

  11. Schuchmann, L. Spinal muscular atrophy of the scapulo-peroneal type. Z. Kinderheilk. 109: 118-123, 1970. [PubMed: 5494204, related citations] [Full Text]

  12. Tawil, R., Myers, G. J., Weiffenbach, B., Griggs, R. C. Scapuloperoneal syndromes: absence of linkage of the 4q35 FSHD locus. Arch. Neurol. 52: 1069-1072, 1995. [PubMed: 7487558, related citations] [Full Text]

  13. Walter, M. C., Reilich, P., Huebner, A., Fischer, D., Schroder, R., Vorgerd, M., Kress, W., Born, C., Schoser, B. G., Krause, K. H., Klutzny, U. Bulst, S. Frey, J. R., Lochmuller, H. Scapuloperoneal syndrome type Kaeser and a wide phenotypic spectrum of adult-onset, dominant myopathies are associated with the desmin mutation R350P. Brain 130: 1485-1496, 2007. [PubMed: 17439987, related citations] [Full Text]

  14. Zellweger, H., McCormick, W. F. Scapuloperoneal dystrophy and scapuloperoneal atrophy. Helv. Paediat. Acta 23: 643-649, 1968. [PubMed: 5717695, related citations]


Victor A. McKusick - updated : 2/19/2008
Cassandra L. Kniffin - updated : 7/2/2002
Orest Hurko - updated : 2/22/1996
Creation Date:
Victor A. McKusick : 6/2/1986
carol : 10/02/2023
alopez : 03/20/2023
carol : 12/25/2022
joanna : 03/24/2017
carol : 08/08/2016
carol : 04/24/2012
terry : 10/13/2010
alopez : 2/22/2008
alopez : 2/22/2008
terry : 2/19/2008
mgross : 3/17/2004
carol : 7/2/2002
ckniffin : 7/2/2002
carol : 6/28/2002
alopez : 3/13/1998
jamie : 10/25/1996
mark : 10/23/1996
terry : 10/7/1996
terry : 4/15/1996
mark : 2/22/1996
terry : 2/12/1996
mimadm : 3/25/1995
davew : 7/18/1994
carol : 4/28/1994
warfield : 4/21/1994
supermim : 3/16/1992
carol : 8/7/1991

# 181400

SCAPULOPERONEAL SYNDROME, NEUROGENIC, KAESER TYPE; SCPNK


Alternative titles; symbols

KAESER SYNDROME
STARK-KAESER SYNDROME
SCAPULOPERONEAL SYNDROME, NEUROGENIC TYPE, OF KAESER


SNOMEDCT: 1208615009;   ORPHA: 85146;   DO: 0111551;  


Phenotype-Gene Relationships

Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
Gene/Locus Gene/Locus
MIM number
2q35 Scapuloperoneal syndrome, neurogenic, Kaeser type 181400 Autosomal dominant 3 DES 125660

TEXT

A number sign (#) is used with this entry because of evidence that Kaiser-type neurogenic scapuloperoneal syndrome (SCPNK) is caused by heterozygous mutation in the DES gene (125660) on chromosome 2q35.


Clinical Features

Peroneal atrophy is accompanied by bilateral foot drop and talipes equinovarus. Following atrophy of the lower legs, the shoulder girdle is involved. Bulbar involvement is late. Autopsy shows muscular atrophy and involvement of caudal cranial nuclei. Palmer (1932) described a family with 8 persons affected, the earliest having onset about 1800. Davidenkow (1939) suggested that cases reported by Wohlfart (see juvenile muscular atrophy, 253400 and 158600) were the same as those he designated scapuloperoneal amyotrophy.

Kaeser (1965) reported a kindred (kindred F) in which 12 members in 5 generations had neurogenic scapuloperoneal syndrome in an autosomal dominant pattern of inheritance. Age at onset was between 30 and 50 years and followed a slowly progressive course. In the first 3 generations, weakness and atrophy started in the legs and spread to the thighs and pelvic girdle, resulting in paraplegia. In the fifth generation, the atrophies extended to the shoulder girdle, upper arms, neck, face, pharynx, and external eye muscles. Histologic examination at autopsy in 1 patient showed that the atrophies were neurogenic in origin, similar to those in Wohlfart-Kugelberg-Welander muscular atrophy. Kindred F, however, demonstrated significant differences from the cases reported by Davidenkow (1939) and from Wohlfart-Kugelberg-Welander juvenile muscular atrophy. Kaeser (1965) concluded that the scapuloperoneal syndrome is a descriptive term comprising various myopathies, peroneal muscular atrophies, and spinal muscular atrophies.

Emery et al. (1968) and Schuchmann (1970) reported sporadic childhood cases with electromyographic and biopsy evidence of neurogenic disease; motor nerve conduction velocities were borderline or normal, suggesting anterior horn cell pathology. Kazakov et al. (1976) provided a follow-up on the kindred reported by Davidenkow (1939). The disorder in many ways resembled Landouzy-Dejerine facioscapulohumeral muscular dystrophy (158900). There are both myopathic (see 608358) and neurogenic dominant forms of the scapuloperoneal syndrome. Emery (1981) described a large kindred in the West of Scotland. Ferguson-Smith and McKusick (1981) saw a brother and sister who clearly had this disorder. The sister had been diagnosed as having Charcot-Marie-Tooth disease and the brother muscular dystrophy. Their disease was neurogenic scapuloperoneal syndrome.

Tawil et al. (1995) described a 3-generation kindred in which 7 members were affected with neurogenic scapuloperoneal syndrome in which nerve conduction velocities showed evidence of a mild demyelinating polyneuropathy and electromyography demonstrated acute and chronic denervation in both proximal and distal muscles. The proband fulfilled the diagnostic criteria for facioscapulohumeral dystrophy (158900), but none of the other affected members had facial weakness. Linkage to markers on 4q35 was excluded, demonstrating this to be a genetically distinct disorder.

Walter et al. (2007) studied the large, multigenerational kindred first described by Kaeser (1964, 1965) with a peculiar scapuloperoneal distribution of weakness and atrophy, inherited in an autosomal dominant fashion, named scapuloperoneal syndrome type Kaeser. A large clinical variability was recognized, even within the same family, ranging from scapuloperoneal (n = 2, 12%), limb-girdle (n = 10, 60%), and distal phenotypes (n = 3, 18%) with variable cardiac (n = 7, 41%) or respiratory involvement (n = 7, 41%). Facial weakness, dysphagia, and gynecomastia were frequent additional symptoms. Affected men seemingly carried a higher risk of sudden, cardiac death as compared to affected women. Histologic and immunohistochemical examination of muscle biopsy specimens revealed a wide spectrum of findings ranging from near normal or unspecific pathology to typical, mild fibrillar changes with accumulation of desmin.


Inheritance

The transmission pattern of SCPNK in the families studied by Walter et al. (2007), including the family reported by Kaeser (1964, 1965), was consistent with autosomal dominant inheritance.


Molecular Genetics

By genetic analysis of the original kindred described by Kaeser (1964), Walter et al. (2007) found possible linkage to the gene encoding desmin and identified a heterozygous missense mutation of the desmin gene (R350P; 125660.0016) cosegregating with the disorder. Moreover, Walter et al. (2007) found the R350P mutation in 4 unrelated German families, which allowed for genotype-phenotype correlations in a total of 15 patients carrying the same mutation. This study suggested that the clinical and pathologic variability generally observed in desminopathies may not be attributed to the nature of the DES mutation alone, but may be influenced by additional genetic and epigenetic factors such as gender. Walter et al. (2007) suggested that mutations of the desmin gene should be considered early in the diagnostic workup of any adult-onset, autosomal dominant myopathy, even if specific myofibrillar pathology is absent.


See Also:

Gharbi Ben Ayed et al. (1993); Ricker et al. (1968); Zellweger and McCormick (1968)

REFERENCES

  1. Davidenkow, S. Scapuloperoneal amyotrophy. Arch. Neurol. Psychiat. 41: 694-701, 1939.

  2. Emery, A. E. H. Personal Communication. Edinburgh, Scotland 7/9/1981.

  3. Emery, E. S., Fenichel, G. M., Eng, G. A spinal muscular atrophy with scapuloperoneal distribution. Arch. Neurol. 18: 129-133, 1968. [PubMed: 5636068] [Full Text: https://doi.org/10.1001/archneur.1968.00470320031003]

  4. Ferguson-Smith, M. A., McKusick, V. A. Personal Communication. Glasgow, Scotland and Baltimore, Md. 7/9/1981.

  5. Gharbi Ben Ayed, A., Samoud, A., Ben Dridi, M. F. Amyotrophie scapulo-peroniere d'origine neurogene type Stark-Kaeser: etude d'une observation familiale. Arch. Franc. Pediat. 50: 135-137, 1993. [PubMed: 8343020]

  6. Kaeser, H. E. Die familiaere scapuloperoneale Muskelatrophie. Dtsch. Z. Nervenheilkd. 186: 379-394, 1964. [PubMed: 14326018]

  7. Kaeser, H. E. Scapuloperoneal muscular atrophy. Brain 88: 407-418, 1965. [PubMed: 5828910] [Full Text: https://doi.org/10.1093/brain/88.2.407]

  8. Kazakov, V. M., Bogorodinsky, D. K., Skorometz, A. A. The myogenic scapulo-peroneal syndrome. Muscular dystrophy in the K. kindred: clinical study and genetics. Clin. Genet. 10: 41-50, 1976. [PubMed: 949863] [Full Text: https://doi.org/10.1111/j.1399-0004.1976.tb00007.x]

  9. Palmer, H. D. Familial scapuloperoneal amyotrophy. Arch. Neurol. Psychiat. 28: 473-477, 1932.

  10. Ricker, K., Mertens, H. G., Schimrigk, K. The neurogenic scapuloperoneal syndrome. Europ. Neurol. 1: 257-274, 1968. [PubMed: 5696601] [Full Text: https://doi.org/10.1159/000113668]

  11. Schuchmann, L. Spinal muscular atrophy of the scapulo-peroneal type. Z. Kinderheilk. 109: 118-123, 1970. [PubMed: 5494204] [Full Text: https://doi.org/10.1007/BF00438809]

  12. Tawil, R., Myers, G. J., Weiffenbach, B., Griggs, R. C. Scapuloperoneal syndromes: absence of linkage of the 4q35 FSHD locus. Arch. Neurol. 52: 1069-1072, 1995. [PubMed: 7487558] [Full Text: https://doi.org/10.1001/archneur.1995.00540350055017]

  13. Walter, M. C., Reilich, P., Huebner, A., Fischer, D., Schroder, R., Vorgerd, M., Kress, W., Born, C., Schoser, B. G., Krause, K. H., Klutzny, U. Bulst, S. Frey, J. R., Lochmuller, H. Scapuloperoneal syndrome type Kaeser and a wide phenotypic spectrum of adult-onset, dominant myopathies are associated with the desmin mutation R350P. Brain 130: 1485-1496, 2007. [PubMed: 17439987] [Full Text: https://doi.org/10.1093/brain/awm039]

  14. Zellweger, H., McCormick, W. F. Scapuloperoneal dystrophy and scapuloperoneal atrophy. Helv. Paediat. Acta 23: 643-649, 1968. [PubMed: 5717695]


Contributors:
Victor A. McKusick - updated : 2/19/2008
Cassandra L. Kniffin - updated : 7/2/2002
Orest Hurko - updated : 2/22/1996

Creation Date:
Victor A. McKusick : 6/2/1986

Edit History:
carol : 10/02/2023
alopez : 03/20/2023
carol : 12/25/2022
joanna : 03/24/2017
carol : 08/08/2016
carol : 04/24/2012
terry : 10/13/2010
alopez : 2/22/2008
alopez : 2/22/2008
terry : 2/19/2008
mgross : 3/17/2004
carol : 7/2/2002
ckniffin : 7/2/2002
carol : 6/28/2002
alopez : 3/13/1998
jamie : 10/25/1996
mark : 10/23/1996
terry : 10/7/1996
terry : 4/15/1996
mark : 2/22/1996
terry : 2/12/1996
mimadm : 3/25/1995
davew : 7/18/1994
carol : 4/28/1994
warfield : 4/21/1994
supermim : 3/16/1992
carol : 8/7/1991