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Abstract
Introduction Arthrogryposis multiplex congenita (AMC) refers to a clinical presentation of congenital contractures involving two or more body areas. More than 400 distinct conditions may lead to AMC, making the aetiological diagnosis challenging. The objective of this work was to set up evidence-based recommendations for the diagnosis of AMC by taking advantage of both data from our nation-wide cohort of children with AMC and from the literature.
Material and methods We conducted a retrospective single-centre observational study. Patients had been evaluated at least once at a paediatric age in the AMC clinic of Grenoble University Hospital between 2007 and 2019. After gathering data about their diagnostic procedure, a literature review was performed for each paraclinical investigation to discuss their relevance.
Results One hundred and twenty-five patients were included, 43% had Amyoplasia, 27% had distal arthrogryposis and 30% had other forms. A definitive aetiological diagnosis was available for 66% of cases. We recommend a two-time diagnostic process: first, non-invasive investigations that aim at classifying patients into one of the three groups, and second, selected investigations targeting a subset of patients.
Conclusion The aetiological management for patients with AMC remains arduous. This process will be facilitated by the increasing use of next-generation sequencing combined with detailed phenotyping. Invasive investigations should be avoided because of their limited yield.
- diagnosis
- pediatrics
- genetics
- medical
- neuromuscular diseases
- arthrogryposis multiplex congenita
- amyoplasia
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information. All data considered as mandatory for the understanding of our manuscript are included in the article or available in the supplementary tables. Additional data may be obtained on request.
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- diagnosis
- pediatrics
- genetics
- medical
- neuromuscular diseases
- arthrogryposis multiplex congenita
- amyoplasia
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information. All data considered as mandatory for the understanding of our manuscript are included in the article or available in the supplementary tables. Additional data may be obtained on request.
Footnotes
Contributors Guarantor: KD. Conceptualisation: PLT, KD. Data curation: PLT, KD. Formal analysis: PLT, KD. Funding acquisition: KD. Investigation: PLT. Project administration: KD, PSJ. Resources: VB, GM, GB, JR, XL, JF. Supervision: KD. Validation: P-SJ. Visualisation: PLT, KD. Writing-original draft: PLT, KD. Writing-review and editing: VB, MG, GB-L, JR, XL, JF, P-SJ.
Funding This work was financially supported by the Reference Centre for Congenital Anomalies/Arthrogryposis of Grenoble-Alpes University Hospital, the Direction de la Recherche Clinique et de l’Innovation of Grenoble-Alpes University Hospital (grant to KD, Paediatric and Adult Registry on ARThrogryposis PARART project) and Grenoble-Alpes University.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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