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Case report identifies MTM1 mutation in neonate with X-linked centronuclear myopathyWhat happens when a newborn can't breathe? A rare muscle disease story

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Key Takeaway
Consider XLCNM in male neonates with severe hypotonia, respiratory failure, and family history of neonatal male death.

A case report and systematic literature review details a male neonate presenting with apnea, cyanosis, and severe hypotonia immediately after birth, requiring ventilator support. The patient had a family history of neonatal death in a male sibling. Whole-exome sequencing revealed a hemizygous nonsense mutation in MTM1 (c.373C > T, p.Gln125Ter), confirming a diagnosis of X-linked centronuclear myopathy (XLCNM). Maternal heterozygosity was verified by Sanger sequencing.

Clinical findings included anemia of chronic disease, hypoproteinemia, vitamin D insufficiency, mild hepatic dysfunction, laryngomalacia, and a patent foramen ovale. The infant had persistent hypotonia and feeding difficulties. The family declined further treatment, and the patient was discharged for palliative care, dying shortly after from respiratory failure.

No specific intervention, comparator, or safety data were reported. The report emphasizes the need for heightened clinical awareness of XLCNM in male neonates with severe hypotonia and respiratory failure, particularly with a suggestive family history. It summarizes current therapeutic and research advances and discusses supportive strategies that may optimize survival and quality of life.

This evidence is limited to a single case report without comparative data, statistical analysis, or follow-up. The findings highlight a severe neonatal presentation but cannot establish treatment efficacy or generalizable outcomes.

Imagine a baby born so weak he can't breathe. That's what happened to a newborn boy who immediately needed a ventilator. His doctors discovered he had a rare, inherited muscle disease called X-linked centronuclear myopathy, or XLCNM. This happens when a specific gene, called MTM1, has a serious error that stops muscles from working properly.

The baby had a family history that gave doctors a clue—a male sibling had died as a newborn. Genetic testing confirmed the baby had the same harmful mutation in the MTM1 gene, and his mother carried it. Beyond the profound muscle weakness, the baby also faced anemia, liver issues, and other complications. His family chose palliative care, and he died from respiratory failure shortly after going home.

This detailed report of one tragic case reminds doctors to consider this rare disease when they see a very weak newborn, especially if there's a family history of similar losses. The authors also reviewed what's known about the condition to summarize current care strategies. It's a powerful, sobering look at a severe illness, but it's crucial to remember this is a single story, not a study that can predict outcomes for others.

What this means for you:
A single case shows the severe impact of a rare genetic muscle disease in newborns.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedMar 2026
View Original Abstract ↓
BackgroundX-linked centronuclear myopathy (XLCNM) is a rare congenital neuromuscular disorder caused by pathogenic variants in MTM1, typically presenting with severe neonatal hypotonia, respiratory failure, and poor survival. Early diagnosis is essential for prognosis and genetic counseling, though clinical recognition is often challenging.Case presentationWe report a male infant, born at 38 + 1 weeks via cesarean section, who presented immediately after birth with apnea, cyanosis, hypotonia, and poor responsiveness. Despite resuscitation and intensive care for neonatal asphyxia and sepsis, he remained ventilator-dependent with persistent hypotonia and feeding difficulties. Laboratory evaluation showed anemia of chronic disease, hypoproteinemia, vitamin D insufficiency, and mild hepatic dysfunction. Imaging revealed laryngomalacia and a patent foramen ovale. Given the family history of neonatal death in a male sibling, whole-exome sequencing (WES) was performed and identified a hemizygous nonsense mutation in MTM1 (NM_000252.2): c.373C > T (p.Gln125Ter), confirming XLCNM. Maternal heterozygosity was verified by Sanger sequencing, consistent with X-linked recessive inheritance. In view of the severe clinical course and poor prognosis, the family declined further treatment. The patient was discharged for palliative care and died shortly after from respiratory failure.ConclusionThis case reveals the importance of early recognition and genetic diagnosis of XLCNM, particularly in neonates with unexplained hypotonia and a suggestive family history. Through our literature review, we emphasize the need for heightened clinical awareness, summarize current therapeutic and research advances, and discusses supportive strategies that may optimize survival and quality of life in affected infants.
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