A recent study published in the Journal of Neurology identified a number of severe and potentially life-threatening comorbidities that may occur in patients with Duchenne muscular dystrophy (DMD).
DMD is a complex disease that has the capacity to impact several organ systems, raising concerns regarding comorbidities. Patients may experience not only muscular and pulmonary complaints, for example, but also many less-common conditions that may not typically be associated with DMD.
In their study, the authors sought to identify these less-common comorbidities to better understand their potential impact on quality of life and life expectancy.
The study included 129 male patients living in Sweden with DMD. Of these individuals, 56% experienced one or more severe complications, the most common of which were gastrointestinal and cardiovascular complications.
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The authors also identified several gastrointestinal symptoms not classified as severe complications, namely difficulty swallowing and motility, which is the ability of the muscles to help push food and waste through the digestive tract.
Life-threatening arrythmias were the most common cardiac event and were fatal in five of 14 individuals. Heart attacks also occurred in five participants, and were fatal in two.
Additionally, the investigators found that bladder dysfunction was the most common kidney complication, occurring in 15 individuals. Acute kidney injury was also reported in five patients, often occurring within three months of death.
Fractures were fairly common among participants, with 47.9% of patients having at least one fracture. Fractures in the femur were most common, accounting for 35 of the 121 total fractures. Patients who received glucocorticoids were more likely to experience recurrent fractures than those who did not.
Lastly, the investigators found that 10.7% of patients experienced a vascular event, with a median age of onset of 23.5 years. Cerebrovascular conditions, which impact both the brain and blood vessels, were found in 4.9% of individuals.
“In conclusion, our study emphasizes the importance of raising awareness in regards to less common, severe comorbidities in DMD, especially in light of the increasing life expectancy,” the study’s authors noted. “Continuing surveillance after transition to adult care is particularly important to ensure that evolving, potentially life-threatening complications are not overlooked amid the increasing cardiopulmonary burden of disease.”
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