Duchenne Muscular Dystrophy: An Atypical Adult Presentation and Comprehensive Literature Review with Management Recommendations

Sayed Ali

Department of Pediatrics, Swat Medical Complex, Teaching Hospital Saidu Sharif Swat, Pakistan.

Majid Ali Shah

Department of Pediatrics, Hayatabad Medical Complex, Peshawar, Pakistan.

Muhammad Haseeb Khan

Department of Internal Medicine, Hayatabad Medical Complex, Peshawar, Pakistan.

Zaryab Ali Shah

Department of Internal Medicine, Hayatabad Medical Complex, Peshawar, Pakistan.

Ahtesham Waheed

Department of Dermatology, Pakistan Institute of Medical Sciences, Pakistan.

Aftab Ahmad

Cork University Hospital, Cork, Ireland.

Haleema Tahir

Kohat University of Science and Technology, Kohat, Pakistan.

Komal Fatima

Spruce Medical Walk-In Clinic and Family Practice, Ontario, Canada.

Bilawal Mehmood Khan

Department of Cardiology, Pakistan Institute of Medical Sciences, Pakistan.

Najeeb Ullah khan

Department of Plastic Surgery, Pakistan Institute of Medical Sciences, Pakistan.

Muhammad Shehzad

Department of Internal Medicine, Pakistan Institute of Medical Sciences, Pakistan.

Aisha Maqbool

Department of Internal Medicine, Pakistan Institute of Medical Sciences, Islamabad. Pakistan.

Furqan Ul Haq *

Department of Radiation Oncology, Shifa International Hospital Islamabad, Pakistan.

*Author to whom correspondence should be addressed.


Abstract

Background: Duchenne Muscular Dystrophy (DMD), a severe X-linked recessive disorder caused by mutations in the DMD gene and subsequent dystrophin deficiency, leads to progressive muscle degeneration, loss of ambulation, and life-limiting cardiorespiratory failure. While classically presented in early childhood, significant advancements in multidisciplinary care have dramatically extended survival, transforming DMD into a chronic condition requiring lifelong management, including transition to adult care. Concurrently, the therapeutic landscape is evolving with the advent of mutation-targeted molecular therapies alongside established supportive care standards.

Aim and Objectives: This paper integrates the presentation of a rare case of DMD diagnosed in a 34-year-old male in Peshawar, Pakistan, with a comprehensive literature review. The objective is to synthesize current evidence-based knowledge regarding the etiology, diagnosis, prognostic factors, and multidisciplinary management of DMD across its full clinical spectrum. The review provides a framework for recognizing typical and atypical presentations, anticipating complications, implementing guideline-based care strategies, navigating transition issues, and understanding the potential and limitations of emerging therapies, with consideration for global perspectives and resource variability thereby highlighting current challenges and areas requiring further investigation.

Methodology: A case report methodology was employed, utilizing clinical records and diagnostic findings from the presented patient. This was combined with a comprehensive literature review synthesizing information from searches of biomedical databases (PubMed, Cochrane Library), key systematic reviews and meta-analyses, international care guidelines, patient registry data, and relevant primary research, focusing on evidence pertinent to the review's objectives.

Synthesis and Conclusion: DMD manifests a spectrum of severity influenced by genetic factors and potentially modulated by environmental and socioeconomic variables. Accurate diagnosis via genetic testing is paramount for appropriate management and therapy eligibility. While standardized multidisciplinary care has significantly improved outcomes, transforming DMD care necessitates addressing long-term adult needs and transition planning. Novel molecular therapies offer promise but face substantial challenges related to delivery, immunogenicity, safety, cost, and equitable global access. Optimizing outcomes requires integrating established comprehensive care standards with appropriate application of new diagnostic and therapeutic advances, tailored to individual patient needs across diverse global contexts. This review provides a synthesized overview to support clinicians in navigating the complexities of DMD diagnosis and lifelong management.

Keywords: Duchenne Muscular Dystrophy (DMD), muscle degeneration, loss of ambulation, immunogenicity


How to Cite

Ali, Sayed, Majid Ali Shah, Muhammad Haseeb Khan, Zaryab Ali Shah, Ahtesham Waheed, Aftab Ahmad, Haleema Tahir, et al. 2025. “Duchenne Muscular Dystrophy: An Atypical Adult Presentation and Comprehensive Literature Review With Management Recommendations”. Biotechnology Journal International 29 (3):28-60. https://doi.org/10.9734/bji/2025/v29i3776.

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