Program Operations Manual System (POMS)
   TN 38 (09-20)
   DI 23022.520 Ullrich Congenital Muscular Dystrophy
   
   
   
   
      
         
            
            
            
         
         
            
            
               
               | COMPASSIONATE ALLOWANCES INFORMATION | 
         
         
            
            
               
               | ULLRICH
                     CONGENITAL MUSCULAR DYSTROPHY | 
            
               
               | ALTERNATE NAMES | UCMD; Ullrich Disease; Ullrich Scleroatonic Muscular Dystrophy; Muscular Dystrophy
                     Scleroatonic
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               | DESCRIPTION | Ullrich Congenital Muscular Dystrophy (UCMD) is a rare form of congenital muscular dystrophy that is caused by mutations in the
                     gene coding for the alpha chains of collagen VI (COL6A1, COL6A2, COL6A3), adversely
                     affecting the production of collagen VI, which is needed for normal connective tissue
                     and muscle function.
                   UCMD is present at birth. Children born with UCMD generally have . Intelligence and
                     brain activity are normal. Cardiac function is normal.
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               | DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM/ICD-10-CM CODING | Diagnostic testing: The diagnosis is supported by:
                   
                     
                        
                           • 
                              Abnormal immunoreactivity for collagen VI on muscle biopsies;
                        
                     
                        
                           • 
                              Serum creatine kinase (CK) concentration; and
                        
                           • 
                              Immunostaining of muscle tissue.
                        
                           • 
                              EMG revealing myopathic changes with normal nerve conduction velocity (NCV). Physical
                        findings: Physical symptoms include:
                   
                     
                        
                           • 
                              Loss of muscle tone (hypotonia);
                        
                           • 
                              Loose joints (hyperextensibility);
                        
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                              Muscle weakness in the hands and feet;
                        
                     
                        
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                              Curvature of the spine (kyphosis);
                        
                     
                        
                     
                        
                     
                        
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                              Respiratory insufficiency;
                        
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                              Round face with drooping of the lower lids;
                        
                     
                        
                           • 
                              Skin changes (hyperkeratosis)  ICD-9:
                     359.0 ICD-10:
                        G71.2
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               | PROGRESSION | Children with UCMD experience a progressive loss of ambulation and die of respiratory
                     failure in the first decade of life.
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               | TREATMENT | There is currently no cure for UCMD. Callipers (leg splints) are often used to assist
                     a child to walk, and sleep studies are used to monitor the breathing quality during
                     sleep.
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               | SUGGESTED PROGRAMMATIC ASSESSMENT* | 
            
               
               | Suggested MER for
                     Evaluation: 
                     
                        
                           • 
                              Clinical examination including a description of physical findings;
                        
                     
                        
                     
                        
                           • 
                              Electromyography or nerve conduction tests; and
                        
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               | Suggested Listings for
                     Evaluation: | 
            
               
               | DETERMINATION | LISTING | REMARKS | 
            
               
               | Meets | 110.08 |  | 
            
               
               | 111.13 |  | 
            
               
               | Equals |  |  | 
            
               
               | * Adjudicators may, at their discretion, use the Medical Evidence of Record or the
                  listings suggested to evaluate the claim. However, the decision to allow or deny the
                  claim rests with the adjudicator. |