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Calcium and magnesium content in fetuses at risk and prenecrotic Duchenne muscular dystrophy

From the Departments of Neurology and Pathology (Dr. Bertorini), Surgery (Dr. Bhattacharya), and Medicine (Dr. Palmieri), University of Tennessee Center for the Health Sciences, Memphis, TN; the Neuromuscular Research Center, Istituto Neurologico, "C. Besta" (Drs. Cornelio, Dones, and Dworzak), and the First Department of Obstetrics and Gynecology (Dr. Brambati), University of Milano, Milano, Italy.

We measured calcium (Ca) and magnesium (Mg) content in muscles of fetuses at risk of Duchenne muscular dystrophy (DMD) and in a premature infant who later developed typical DMD. There was a three- to six-fold increase in muscle Ca in the fetuses and in the premature infant. In contrast to our previous reports of reduced muscle Mg in DMD children, there was an 18 to 57% increase of Mg in the fetuses at risk. Opaque and Ca-positive fibers, rarely observed in normal fetuses, were numerous in fetuses at risk and in the premature infant. No necrotic fibers were detected in the fetuses or the premature infant. These findings suggest that excessive Ca accumulation precedes necrosis in DMD. Other factors related to growth and development that occur after birth may trigger the necrosis that follows muscle Ca accumulation.

Address correspondence and reprint requests to Dr. Bertorini, University of Tennessee Center for the Health Sciences, Department of Neurology, 956 Court Avenue, Room 2B03, Memphis, TN 38163.

This work was supported in part by grants of the Legato "Dino Ferrari" and the Muscular Dystrophy Association of America.

Presented in part at the International Symposium on Facts and Perspectives in Muscular Dystrophy, June 1983, Modena, Italy.

Accepted for publication March 7, 1984.

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