Case Study for Duchenne Muscular Dystrophy:
A 9 years old boy from Kenya was admitted to our hospital for treatment of Duchenne Muscular Dystrophy.
Diagnosis: Duchenne Muscular Dystrophy (DMD)
Clinical history: K/C/O DMD at the age of 6 years. FTND (full term normal delivery) 3.9kg with normal milestones.
Associated complaints: Walking on toes, twisted at age of 5 years as per narration of mother. Creatine kinase and CRP levels increased. N/H/O convulsions, HTN/DM/TB.
Surgery: Patient was suggested for understand testis operation.
Presently on no medications.
Family History: 13 years brother normal, 9years old boy (patient) DMD.
In DMD major factors responsible are:
• Calmitine of the mitochondrial matrix of control muscle gets degraded in the presence of mitochondrial extracts of muscle from DMD patients.
• Certain enzymes involved in ATP synthesis would be inhibited, resulting in the muscular degeneration characteristic of this myopathy.
The stem cell plays a major role for cure due to their basic correctors of Angiogenesis & Differentiation, so the below protocol was adopted for treatment.
Cellular therapy includes:
• Bone marrow transplant
• Adipose transplant (fat derived)
• Platelet rich plasma (PRP)
Stem cells exist in all tissues in human body and classified as totipotent, pluripotent, multipotent depending on tissue type.
Stem cells are classified as Adult stem cells and embryonic stem cells, which are further classified according to the way they are derived and sources tissues like, Mesenchymal stem cells(MSC’s), Haematopoietic stem cells(HSC’s) and induced pluripotent stem cells(iPS)cells are the major types of stem cells.
Autologous stem cells are derived from patient’s own body and can be obtained from bone marrow, adipose tissue and Peripheral blood.
We use Mesenchymal stem cells derived from bone marrow, adipose tissue, which are self renewing cells derived from adult tissues that can from a number of cells or tissues that are usually restricted to a particular germ layer.
The major advantage of using MSC’s is the ease of harvest and lack of immunoreactivity since they are derived from autologous sources.
There is no risk of a rejection reaction, it is safe and effective and the most important thing is that the stem cells treatment has a very measurable, positive effect. These are then processed in tissue culture lab to isolate stem cells which are then given intravenously, intra-articularly at different joints and intra-muscular at various points under general anaesthesia (mild sedation).
Following supplements were advised for the patient:
• Omega-3 fatty acids, such as fish oil, 1-2 capsules or 1 tablespoonful oil 1-2 times a day, to help decrease inflammation and improve immunity.
• A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-Vitamins and trace minerals.
• Calcium and Vitamin-D supplement, 1-2 tablets daily, for support of muscle and skeletal.
• Co-enzyme Q10, 100-200mg at bedtime, for antioxidant, immune and muscular support.
• N-acetyl cysteine, 200mg, for antioxidant effects.
• Acetyl-L-carnitine,500mg daily, for antioxidant and muscle protective activity.
• Amino acids, including glutamine and arginine for muscle protection
• Probiotic supplement, 5-10 billion CFUs a day for maintenance of gastrointestinal and immune health.
• Creatine, 5-7 gms daily, when needed for muscle weakness and wasting.
• L-theanine, 200mg 1-3 times daily, for nervous system support.
Patient showed good improvement symptomatically.
• Before the procedure he use to pass loose watery stools and use to have frequent pain in abdomen, but post treatment he is passing normal stools and no pain in abdomen.
• Active exercises were given for bilateral upper limb and lower limb, bridging, trunk rotation, IFT given after which he started getting movements in the joints.
• TA, Hamstring, iliopsoas stretching done and other exercises protocol were given.
The patient is still under observation and follow up for full recovery.
Click here to watch patient’s mother video testimonial