The aim of this study was to evaluate the pulmonary condition in a large family with Charcot-Marie-Tooth disease type 2 (CMT2). Eighteen participants diagnosed with CMT2 and 20 healthy individuals were evaluated by spirometry and maximal expiratory and maximal inspiratory pressures (MEP and MIP, respectively). Clinical disability was measured with CMT neuropathy score (CMTNS; range 0-36). One control group (CG) comprising 20 individuals, matched for age, sex and body mass index, were used for comparison. Eight patients were female (44.5%) and 10 patients were male (55.5%); mean age was 31.8 years (range 11-79) and CMTNS range was 6-26. Differences between CMT2 and CG in the spirometry and respiratory muscle strength were statistically significant for all dimensions. There were significant correlations between CMTNS and MIP (Pearson = -0.581) and MEP (Pearson = -0.5090). The results of this study show that patients with CMT, in spite of not showing clinical signs of advanced respiratory impairment, may present subclinical respiratory changes. The respiratory comprise in the CMT disease can be silent and insidious without presenting characteristic clinical signals.

1.
Mersiyanova IV, Ismailov SM, Polyakov AV, et al: Screening for mutations in the peripheral myelin genes PMP22, MPZ and Cx32 (GJB1) in Russian Charcot-Marie-Tooth neuropathy patients. Hum Mutat 2000;15:340-347.
2.
Boentert M, Dziewas R, Heidbreder A, Happe S, Kleffner I, Evers S, Young P: Fatigue, reduced sleep quality and restless legs syndrome in Charcot-Marie-Tooth disease: a web-based survey. J Neurol 2010;257:646-652.
3.
Aboussouan LS, Lewis RA, Shy ME: Disorders of pulmonary function, sleep, and the upper airway in Charcot-Marie-Tooth disease. Lung 2007;185:1-7.
4.
Davis CJ, Bradley WG, Madrid R: The peroneal muscular atrophy syndrome: clinical, genetic, electrophysiological and nerve biopsy studies. I. Clinical, genetic and electrophysiological findings and classification. J Genet Hum 1978;26:311-349.
5.
Harding AE, Thomas PK: The clinical features of hereditary motor and sensory neuropathy types I and II. Brain 1980;103:259-280.
6.
Muglia M, Zappia M, Timmerman V, Valentino P, Gabriele AL, Conforti FL, De Jonghe P, Ragno M, Mazzei R, Sabatelli M, Nicoletti G, Patitucci AM, Oliveri RL, Bono F, Gambardella A, Quattrone A: Clinical and genetic study of a large Charcot-Marie-Tooth type 2A family from southern Italy. Neurology 2001;56:100-103.
7.
Piantino JA, Torres A: Myoclonic seizures in a patient with Charcot-Marie-Tooth disease. Pediatr Neurol 2007;36:118-120.
8.
Sevilla T, Jaijo T, Nauffal D, Collado D, Chumillas MJ, Vilchez JJ, et al: Vocal cord paresis and diaphragmatic dysfunction are severe and frequent symptoms of GDAP1-associated neuropathy. Brain 2008;131(pt 11):3051-3061.
9.
Snyder RW, Mishel HS, Christensen GC 3rd: Phrenic nerve involvement in Charcot-Marie-Tooth disease. Chest 1990;98:1043.
10.
Burakgazi AZ, Höke A: Respiratory muscle weakness in peripheral neuropathies. J Peripher Nerv Syst 2010;15:307-313.
11.
Butinar D, Starr A, Vatovec J: Brainstem auditory evoked potentials and cochlear microphonics in the HMSN family with auditory neuropathy. Arch Eur J Physiol 2000;439(suppl 1):r204-r205.
12.
Verhagen WI, Huygen PL, Gabreëls-Festen AA, Engelhart M, van Mierlo PJ, van Engelen BG: Sensorineural hearing impairment in patients with Pmp22 duplication, deletion, and frameshift mutations. Otol Neurotol 2005;26:405-414.
13.
Horacek O, Chlumsky J, Mazanec R, Kolar P, Andel R, Kobesova A: Pulmonary function in patients with hereditary motor and sensory neuropathy: a comparison of patients with and without spinal deformity. Neuromuscul Disord 2012;22:1083-1089.
14.
Souza CC, Hirotsu C, Neves EL, Santos LC, Costa IM, Garcez CA, Nunes OS, Antunes A: Sleep pattern in Charcot-Marie-Tooth disease type 2: report of family case series. J Clin Sleep Med 2015;11:205-211.
15.
Neves EL, Kok F: Clinical and neurophysiological investigation of a large family with dominant Charcot-Marie-Tooth type 2 disease with pyramidal signs. Arq Neuropsiquiatr 2011;69:424-430.
16.
Shy ME, Blake J, Krajewski K, Fuerst DR, Laura M, Hahn AF, Li J, Lewis RA, Reilly M: Reliability and validity of the CMT neuropathy score as a measure of disability. Neurology 2005;64:1209-1214.
17.
Black LF, Hyatt RE: Maximal respiratory pressures: normal values and relationship to age and sex. Am Rev Respir Dis 1969;99:696-702.
18.
Nanas S, Nanas J, Kassiotis C, Alexopoulos G, Samakovli A, Kanakakis J, Tsolakis E, Roussos C: Respiratory muscle performance is related to oxygen kinetics during maximal exercise and early recovery in patients with congestive heart failure. Circulation 1999;100:503-508.
19.
Hankinson JL, Odencrantz JR, Fedan KB: Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med 1999;159:179-187.
20.
Chen DH, Sul Y, Weiss M, Hillel A, Lipe H, Wolff J, Matsushita M, Raskind W, Bird T: CMT2C with vocal cord paresis associated with short stature and mutations in the TRPV4 gene. Neurology 2010;75:1968-1975.
21.
Nathanson BN, Yu DG, Chan CK: Respiratory muscle weakness in Charcot-Marie-Tooth disease. A field study. Arch Intern Med 1989;149:1389-1391.
22.
Hardie R, Harding AE, Hirsch N, et al: Diaphragmatic weakness in hereditary motor and sensory neuropathy. J Neurol Neurosurg Psychiatry 1990;53:348-350.
23.
Carter GT, Kilmer DD, Bonekat HW, Lieberman JS, Fowler WM Jr: Evaluation of phrenic nerve and pulmonary function in hereditary motor and sensory neuropathy, type I. Muscle Nerve 1992;15:459-462.
24.
Takakura Y, Furuya H, Yamashita K, Murai H, Araki T, Kikuchi H, Ohyagi Y, Yamada T, Kira J: A case of Charcot-Marie-Tooth disease (CMT) type 1 complicated by diabetes mellitus (DM) showing bilateral phrenic nerve palsy. Rinsho Shinkeigaku 2002;42:320-322.
25.
Chan CK, Mohsenin V, Loke J, Virgulto J, Sipski ML, Ferranti R: Diaphragmatic dysfunction in siblings with hereditary motor and sensory neuropathy (Charcot-Marie-Tooth disease). Chest 1987;91:567-570.
26.
Eichacker PQ, Sipiro A, Sherman M, Lazar E, Reichel J, Dodick F: Respiratory muscle dysfunction in hereditary motor sensory neuropathy, type I. Arch Intern Med 1988;148:1739-1740.
27.
Sagliocco L, Orlandi G, Calabrese R, Pellegrinetti A, Baglini O, Castelli F, Baldinotti F, Sartucci F: Electrodiagnostic evidence of phrenic nerve demyelination in Charcot-Marie-Tooth disease 1A. Am J Phys Med Rehabil 2003;82:754-759.
28.
Carter GT, Jensen MP, Galer BS, Kraft GH, Crabtree LD, Beardsley RM, Abresch RT, Bird TD: Neuropathic pain in Charcot-Marie-Tooth disease. Arch Phys Med Rehabil 1998;79:1560-1564.
29.
Goto T, Hurford WE: Postoperative acute respiratory failure following thoracotomy in a patient with Charcot-Marie-Tooth Disease. J Clin Anesth 1994;6:434-436.
30.
Driscoll SW, Skinner J: Musculoskeletal complications of neuromuscular disease in children. Phys Med Rehabil Clin N Am 2008;19:163-194.
31.
Morélot-Panzini C, Fournier E, Donzel-Raynaud C, Dubourg O, Willer JC, Similowski T: Conduction velocity of the human phrenic nerve in the neck. J Electromyogr Kinesiol 2009;19:122-130.
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