Obtaining a definitive genetic diagnosis is an important first step in seeking appropriate care and treatment, learning about potential research or therapies that may become available, and preparing for the future. Patients and their families should consider discussing the implications of obtaining a diagnosis of CMT4J with their physician and a genetic counselor or other specialists who are familiar with the disease management of CMT4J.

Because of low disease awareness and the fact that neurological symptoms are among the earliest signs observed, common misdiagnoses may include chronic inflammatory demyelinating polyneuropathy (CIDP), multiple sclerosis (MS), Guillain-Barré Syndrome (GBS), amyotrophic lateral sclerosis (ALS), and other neuromuscular disorders.

If you believe your child is showing signs or symptoms of CMT4J, tests are available for a physician or other healthcare professional to order to help confirm a diagnosis.

Testing for CMT4J may not be included in standard testing panels; however, a diagnostic genetic test including an expanded exome sequencing panel for CMT4J can be requested to confirm a diagnosis. Many academic and commercial laboratories offer genetic blood testing. Your physician can help you navigate the process or refer you to a geneticist.

A representative is available to help you by calling 1-877-237-5020 or via email at medicalinfo@neurogene.com.

A Researcher’s Perspective on Diagnosis:

“CMT4J is difficult to diagnose without genetic testing because it looks very similar to other neuromuscular illnesses. If you are noticing common symptoms related to muscle weakness and wasting affecting the feet and legs, and overwhelming fatigue, it is important to document these symptoms and discuss with your primary care doctor or request a referral to a neurologist. Your healthcare provider will be able to review your symptoms and order a saliva or blood DNA test. With a positive diagnosis, you or a family member may be eligible to participate in research that could help the community better understand CMT4J.”

Mario Saporta, M.D., Ph.D., is an Assistant Professor of Neurology and Human Genetics at the CMT Center of Excellence at the University of Miami. In addition to his role as a primary care physician, Dr. Saporta’s research and clinical work is focused on neurogenetic and neuromuscular conditions, particularly inherited peripheral neuropathies.

Sources:

  1. Nicholson, G., Lenk, G. M., Reddel, S. W., Grant, A. E., Towne, C. F., Ferguson, C. J., … Meisler, M. H. (2011). Distinctive genetic and clinical features of CMT4J: a severe neuropathy caused by mutations in the PI(3,5)P₂ phosphatase FIG4Brain: a journal of neurology134(Pt 7), 1959–1971. doi:10.1093/brain/awr148. Retrieved June 26, 2019, from link.
  2. Field research conducted by Neurogene and Ten Bridge Communications, July 2019.
  3. Hu, B., McCollum, M., Arpag, S., Moiseev, D., Castoro, R., Burnette, B., Siskind, C., Day, J., Yawn, R., Feely, S., Yan Q., Shy., M., Li, J. (2018). Myelin abnormality in Charcot-Marie-Tooth type 4J recapitulates features of acquired demyelination. Annals of Neurology. 83(4), 756-70. Retrieved September 12, 2019, from link.
  4. Vaccari, I., Carbone, A., Previtali, S. C., Mironova, Y. A., Alberizzi, V., Noseda, R., Rivellini, C., Bianchi, F., Del Carro, U., D’Antonio, M., Lenk, G. M., Wrabetz, L., Giger, R. J., Meisler, M. H., Bolino, A. (2015, Jan. 15). Loss of Fig4 in both Schwann cells and motor neurons contributes to CMT4J neuropathy. Human Molecular Genetics. 24(2), 383-96. Retrieved September 12, 2019, from link.
  5. Martyn, C., & Li, J. (2013, Feb.). Fig4 Deficiency: a newly emerged lysosomal storage disorder? Progress in Neurobiology. doi:10.1016/j.pneurobio.2012.11.001. Retrieved September 12, 2019, from link.
  6. Rajabelly, Y., Adams, D., Latour, P., Attarian, S. (2016, March 23). Hereditary and inflammatory neuropathies: a review of reported associations, mimics, and misdiagnoses. JNNP Online First. BMJ. doi:10.1136/jnnp-2015-310835. Retrieved September 12, 2019, from link.
  7. Zhang X., Chow C. Y., Sahenk Z., Shy, M. E., Meisler, M. H., Li, J. (2008, Aug.). Mutation of FIG4 causes a rapidly progressive, asymmetric neuronal degeneration. Brain. 131(8), 1990–2001. Retrieved September 12, 2019, from link.