Diagnoses of muscular dystrophy in a veterans health system

Topic:

Clinical Management

Poster Number: 34

Author(s):

Carla Zingariello, DO, University of Florida, Yara Mohamed, MD, University of Florida College of Medicine, Magali Jorand-Fletcher, MPH, University of Florida College of Medicine, James Wymer, MD, University of Florida College of Medicine, Peter Kang, MD, Paul and Sheila Wellstone Muscular Dystrophy Center and Dept of Neurology, U of MN Medical School, Sonja Rasmussen, MD, MS, Johns Hopkins School of Medicine

Background:
Early diagnosis of a chronic neuromuscular disease such as muscular dystrophy generally excludes an individual from active-duty military service. However, it is not known whether veterans are sometimes diagnosed with mild forms of muscular dystrophy at a later timepoint.

Methods:
We abstracted clinical and genetic test data on individuals who received care for the diagnosis of muscular dystrophy at the North Florida/South Georgia Veterans Health System over a period of approximately 15 years, a center which served over 176,000 veterans in 2021.

Results:
We identified 8 individuals with genetically confirmed muscular dystrophy. These individuals had oculopharyngeal muscular dystrophy (OPMD, 2 cases), myotonic dystrophy type 1 (DM1, 2 cases), myotonic dystrophy type 2 (DM2, 1 case), Becker muscular dystrophy (BMD, 1 case), distal muscular dystrophy (DD, 1 case), and facioscapulohumeral muscular dystrophy (FSHD, 1 case). The mean age of onset of symptoms was 48 years (range: late 20s to 63 years), and the mean age at time of diagnosis was 58 years (range: 38 to 77 years). Two individuals reported onset of symptoms while they were on active duty. Additionally, several individuals were identified with suspected muscular dystrophy on whom genetic testing was not performed.

Discussion:
There is a paucity of literature on diagnoses of muscular dystrophy among persons who have served in the United States military. Our study demonstrates the importance of neurologists working in Veterans Affairs and Veterans Health Systems being knowledgeable about these diagnoses and methods to confirm them to provide necessary care. When conducting surveillance research on muscular dystrophies, it is important to include veterans health systems as a data source. Mild cases of muscular dystrophy appear to be compatible in some cases with successful completion of military service.