A 6-year-old boy is brought to the emergency department by his parents after he fell while playing soccer and was unable to get up. He has a 10-month history of progressive difficulty climbing stairs and rising from the floor. His parents report that when standing from a seated position on the ground, he "walks his hands up his legs" to push himself upright. On examination, he has a waddling gait, symmetric hip weakness (4/5 bilaterally), and markedly enlarged, firm calf muscles. Serum creatine kinase is 8,500 U/L. The patient's maternal uncle required a wheelchair by age 12 and died at age 18 from respiratory complications. Which of the following proteins is most likely deficient in this patient?

  1. A)Actin
  2. B)Collagen IV
  3. C)DystrophinGABARITO
  4. D)Frataxin
  5. E)Myelin-associated glycoprotein

Explicação

Duchenne muscular dystrophy (DMD) results from mutations in the DMD gene encoding dystrophin, a critical structural protein linking the sarcolemmal cytoskeleton to extracellular matrix via the dystrophin-associated protein complex. Loss of dystrophin causes pr... Ver explicação completa e trilha adaptativa →

Fazer o diagnóstico grátis de USMLE