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Central core disease
Disease definition
Central core disease (CCD) is an inherited neuromuscular disorder characterised by central cores on muscle biopsy and clinical features of a congenital myopathy.
ORPHA:597
Classification level: DisorderSummary
Epidemiology
Prevalence is unknown.
Clinical description
CCD typically presents in infancy with hypotonia and motor developmental delay and is characterized by predominantly proximal weakness, pronounced in the hip girdle. Orthopaedic complications are common and malignant hyperthermia susceptibility (MHS) is a frequent complication.
Etiology
CCD and MHS are allelic conditions, both caused by (predominantly dominant) mutations in the skeletal muscle ryanodine receptor (RYR1) gene, encoding the principal skeletal muscle sarcoplasmic reticulum calcium release channel (RyR1). Altered excitability and/or changes in calcium homeostasis within muscle cells due to mutation-induced conformational changes in the RyR protein are considered to be the main pathogenetic mechanism(s).
Diagnostic methods
The diagnosis of CCD is based on the presence of suggestive clinical features and central cores on muscle biopsy. Muscle MRI may show a characteristic pattern of selective muscle involvement and aid the diagnosis in cases with equivocal histopathological findings. Mutational analysis of the RYR1 gene may provide genetic confirmation of the diagnosis.
Management and treatment
Management is mainly supportive and has to anticipate susceptibility to potentially life-threatening reactions to general anaesthesia. Further evaluation of the underlying molecular mechanisms may provide the basis for future rational pharmacological treatment.
Prognosis
In the majority of patients, weakness is static or only slowly progressive, with a favourable long-term outcome.
A summary on this disease is available in Deutsch (2007) Español (2007) Français (2007) Italiano (2007) Nederlands (2007)
Detailed information
General public
- Article for general public
- English (2011) - Socialstyrelsen
- Svenska (2015) - Socialstyrelsen
Guidelines
- Anesthesia guidelines
- Czech (2019) - Orphananesthesia
- Deutsch (2019) - Orphananesthesia
- English (2019) - Orphananesthesia
- Español (2019) - Orphananesthesia
- Português (2019) - Orphananesthesia
Disease review articles
- Review article
- English (2007) - Orphanet J Rare Dis
- Clinical genetics review
- English (2014) - GeneReviews
Genetic Testing
- Guidance for genetic testing
- English (2011) - Eur J Hum Genet


Additional information