Homozygous mutations in the UDP-N-acetylglucosamine 2-epimerase/. N-acetylmannosamine kinase (GNE) gene cause hereditary inclusion body myopathy type 2 (HIBM2). We describe two unrelated American patients with novel GNE mutations. While one patient followed a typical disease course for HIBM2 with an onset at age 25 and rimmed vacuole pathology on muscle biopsy, the second patient had several features atypical for HIBM2. This patient's onset was at age 55, included distal weakness, quadriceps sparing and respiratory insufficiency. His muscle biopsy showed prominent necrosis without rimmed vacuoles. This study expands the phenotype and illustrates the clinical spectrum of HIBM2 identified in a U.S. based neuromuscular clinic.

Original languageEnglish
Pages (from-to)102-105
Number of pages4
JournalNeuromuscular Disorders
Issue number2
StatePublished - Feb 2011


  • Distal myopathy
  • GNE
  • IBM
  • Rimmed vacuoles


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