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  • Writer's pictureSaeed Anwar Anuj

Limb-girdle muscular dystrophies: life beyond diagnosis

Today, I'd like to delve into a topic that recently caught my attention: Limb-Girdle Muscular Dystrophy (LGMD) and its influence on daily life, notably on aspects like marriage and parenthood. This discussion underscores the importance of comprehending such conditions in depth. The term Limb-Girdle Muscular Dystrophy may seem complex at first encounter. But I will keep the language accessible and straightforward for the lay audience.

LGMD is not a single disease but a collection of conditions that progressively weaken the muscles, predominantly those surrounding the hips and shoulders. Imagine muscles as stretchy bands; with LGMD, these bands gradually lose their elasticity. Important to note that it is a slowly progressing disease, allowing many with LGMD to lead fulfilling lives. LGMD is like a road trip. There are multiple forms, or paths, of LGMD, all leading to the same place—muscle weakness. Each form of LGMD starts with specific 'mutations,' which are like mistakes in a document, in different genes. These genes act like our body's instruction manual. So, each type of LGMD has its own unique pattern, just like there are many possible routes on a map.

Imagine Limb-Girdle Muscular Dystrophy (LGMD) as a large family tree with two main branches: LGMD type 1 (LGMD1) and LGMD type 2 (LGMD2). For LGMD1, getting the condition is like receiving a unique card from just one parent. Within this type are variants like LGMD1A, LGMD1B, and so on. These variants arise because of individual genetic mutations. If a child's parent has this condition, known as autosomal dominant, the child has a 50% chance of inheriting it. LGMD2, on the other hand, is like needing unique cards from both parents to get the condition. There are also different variants of LGMD2, distinguished by their genetic mutations. If a child has one parent carrying this autosomal recessive trait, they have a 25% chance of having the condition. However, if both parents are carriers, there's a 50% chance the child will be a carrier too.

Why does visualizing LGMD as a tree important? It helps doctors determine the specific type of LGMD a person has, ensuring more tailored treatment. Awareness of your LGMD type also offers insights into how it might impact you in the long run. When considering genetic conditions, it's essential to grasp how they're passed down through generations. In autosomal dominant disorders, only one parent must carry the gene for a child to inherit the disease potentially. In contrast, autosomal recessive conditions require both parents to be carriers, leading to a range of inheritance probabilities. This knowledge is vital for those planning families, helping them understand the potential genetic outcomes for their children.

Next, let's talk about something that is close to many hearts: Can an individual diagnosed with LGMD get married, be in a loving relationship, and have children? Good news! The answer is a big yes! Just because someone has LGMD doesn't mean they can't have children or a loving relationship. After all, love is more about our hearts than our bodies. Deciding about marriage after being diagnosed with LGMD can be very demanding and perplexing. It's like trying to find a path in a giant garden maze. It's not only about the changes in your body. Feelings and thoughts also play a big part. This is where talking to a counselor can help. Think of them as someone holding a map of the maze. They can inform you about everything related to marriage and starting a family, and discuss potential risks and considerations, including the likelihood of a child inheriting similar conditions. Their guidance can illuminate the path, making the journey less daunting and more navigable.

Table: Classification and clinical presentation of limb-girdle muscular dystrophies (LGMDs). Note that, the information depicted here are very generalized and based on typical presentations only; individual cases can vary. The asterisks (*) indicate that the inheritance pattern of those types of LGMD can be either autosomal dominant or autosomal recessive, depending on the specific mutation in the gene. © Saeed Anwar

Starting a family is a big decision, especially if you or your partner have LGMD. Before making this decision, I strongly suggest you speak with a well-trained expert genetic counselor. This person is like a guide who knows a lot about family genes. They can help you understand what might happen if you have children. If you're considering this step, you may want to take a test to see more about your genes. After the test, the genetic counselor will talk to you about what the results mean. They can explain things, help you understand your choices, and support you in making decisions that feel right for you.

Having LGMD can sometimes change things in your life, but it doesn't mean you can't have love, get married, or become a parent. Think of life like a road. Even if there are bumps or turns because of LGMD, you can still enjoy all the beautiful moments, just like how you can still appreciate beautiful views on a winding road. Remember, having LGMD is just one part of who you are. It doesn't limit or define everything about you but adds another aspect to your life.

So, I've tried to explain LGMD—what it is, and how it affects love, marriage, and parenthood. Even though it might seem like a lot to take in, it's a starting point for understanding the condition. While I don't plan to go deeper into LGMD right now, I'm always open to learning more as we get new information and questions come up. Remember, you're not alone on this journey. We're moving towards a hopeful future together, one step at a time.


[1] Narayanaswami P, Weiss M, Selcen D, David W, Raynor E, Carter G, Wicklund M, Barohn RJ, Ensrud E, Griggs RC, Gronseth G. Evidence-based guideline summary: diagnosis and treatment of limb-girdle and distal dystrophies: report of the guideline development subcommittee of the American Academy of Neurology and the practice issues review panel of the American Association of Neuromuscular & Electrodiagnostic Medicine. Neurology. 2014; 14;83(16):1453-63.

[2] Angelini C. LGMD. Identification, description, and classification. Acta Myologica. 2020; 39(4):207.

[3] Murphy AP, Straub V. The classification, natural history and treatment of the limb-girdle muscular dystrophies. Journal of neuromuscular diseases. 2015; 2(s2):S7-19.

[4] Vissing J. Limb-girdle muscular dystrophies: classification, clinical spectrum, and emerging therapies. Current opinion in neurology. 2016; 29(5):635-41.

01 August 2023

Saeed Anwar

Edmonton, Canada

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