New TMP3 variant: the phenotypic range of TMP3-related congenital myopathy expands

Mutations in the tropomyosin 3 (TPM3) gene are associated with autosomal dominant and recessive nemaline 1 (NEM1) myopathy, congenital myopathy with disproportionate muscle fibre types and cap myopathy. 

This French-Chilean study reports the case of a 47-year-old man with polycythemia, restricted vital capacity and mild apnea/hypopnea syndrome, requiring non-invasive ventilation.  

Various additional examinations were carried out:  

  • physical assessment: this revealed bilateral ptosis and facial paresis, with an arched high palate and retrognathia; global hypotonia and diffuse axial weakness, including weakness of the neck and upper and lower limb girdles and weakness of foot dorsiflexion.  
  • muscle imaging: whole body MRI showed diffuse fat replacement with a non-specific pattern.
  • molecular analysis: a panel of 122 neuromuscular disorder genes NGS revealed heterozygous SUV c.709G>A (p.Glu237Lys) on exon 8 of TMP3.
  • histological analysis: a biopsy of the deltoid muscle showed a new histological pattern combining a disproportion of fibre types and caps.

These results support the pathogenicity of the new TMP3 variant and extend the phenotypic range of TMP3-related congenital myopathy. 


Novel autosomal dominant TPM3 mutation causes a combined congenital fibre type disproportion-cap disease histological pattern. Bevilacqua JA, Contreras JP, Trangulao A, Hernández Ú, Brochier G, Díaz J, Hughes R, Campero M, Romero NB. Neuromuscul Disord. 2022 May 28:S0960-8966(22)00162-6. doi: 10.1016/j.nmd.2022.05.014. Online ahead of print. PMID: 35688744