Infantile hypertonic myofibrillar myopathy is characterized by the rapid
development of rigid muscles and respiratory insufficiency soon after birth, with
very high mortality. It is extremely rare, and only a few cases having been
reported until now. Here we report four Chinese infants with fatal neuromuscular
disorders characterized by abdominal and trunk skeletal muscle stiffness and
rapid respiratory insufficiency progression. Electromyograms showed increased
insertion activities and profuse fibrillation potentials with complex repetitive
discharges. Immunohistochemistry staining of muscle biopsies showed accumulations
of desmin in the myocytes. Powdery Z-bands with dense granules across sarcomeres
were observed in muscle fibers using electron microscopy. All patients carry a
homozygous c.3G
