Case3: Female, Caucasian, United States, 8 days diagnosis, 2 weeks onset, 1.2 years report
CasePresentingHPOs: HP:0003236, HP:0002194, HP:0003749, HP:0003093, HP:0003273, HP:0003184, HP:0008796, HP:0006380, HP:0001435, HP:0003484, HP:0006589, HP:0003725, HP:0008981, HP:0001270, HP:0001290, HP:0002376 (Increased serum CK, Delayed gross motor development, Pelvic girdle muscle weakness, Limited hip extension, Hip flexion contractures, Decreased hip abduction, Externally rotated hips, Knee flexion contracture, Abnormality of the shoulder girdle musculature, Upper limb muscle weakness, Flaring of lower rib cage, Firm muscles, Calf muscle hypertrophy, Motor delay, Generalized hypotonia, Developmental regression)
HPOsFreeText: Had hyperCKemia since the second week of life (605 IU/L, day 8 of life; 513 IU/L, age 3 months), At 5 months she was unable to hold head up to 90 degrees in prone, unable to sit with slight support but unable to prop-sit, and unable to bear weight on hands in prone with AIMS score at the 10th percentile, PT evaluation at age 6 months revealed progression of delay in gross motor milestones, with AIMS score at the 3rd percentile, Unable to sit upright or unsupported and unable to push up on arms in prone, scored only 20% on Dimension B (Sitting) of the GMFM, Imbalanced weakness was evident in trunk and pelvic musculature with predominant active use of, and positioning in, hip flexion/abduction/external rotation in supine, prone and sitting, decreased use of hip extensors and abdominals, and limitation in the use of abdominal obliques for active trunk rotation, Adduction, Tightness in hip flexors, IT bands, and plantar flexors present, Weakness in abdominals, and in hip extension, ankle dorsiflexion, and ankle eversion persisted at 16 months after walking began, ALT 198 U/L (Normal 5–40 U/L), AST 139 U/L (Normal 15–41 U/L), ALP 248 U/L (Normal 24–170 U/L), Urinary Glc4 7.3 mmol/mol creatinine (Normal ≤8.3 mmol/mol creatinine)