Ivan Martinka, Peter Špalek, Lenka Fajkusová
Facio-scapulo-humeral muscular dystrophy (FSHD) is an autosomal hereditary disease characterized in a typical manner by slowly progressing muscle weakness, especially affecting the mimic, periscapular, shoulder muscles as well as to a lesser extent the distal and proximal muscles of the lower extremities. Typically, it manifests itself in adolescent age, but can occur at any age. Extramuscular manifestations are common in infantile and juvenile forms. Etiopathogenetically, the disease is caused by pathological reactivation of transcription factors (especially DUX4) located in the subtelomeric region of the 4th chromosome (4q35). Based on the molecular genetic nature of the disease, we distinguish 2 forms: FSHD 1 and FSHD 2. For FSHD1, which accounts for 95% of cases, we find pathologically reduced number of repeats of the D4Z4 fragment in the 4q35 region. In FSHD2, the number of repeats is normal, mutations of different genes (SMCHD1, DNMT3B) responsible for regulating transcription factor activity in the 4q35 region are detected. In our paper we describe etiopathogenesis, clinical picture and diagnosis of FSHD. We report epidemiological, clinical and laboratory data of 30 patients with FSHD diagnosed in the Slovak Republic.