{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T12:41:24Z","timestamp":1778503284856,"version":"3.51.4"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T00:00:00Z","timestamp":1567987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007634","name":"Ida Montinin S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007634","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006306","name":"Sigrid Jus\u00e9liuksen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006306","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010135","name":"Finska L\u00e4kares\u00e4llskapet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010135","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005744","name":"Lastentautien Tutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005744","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Mulibrey nanism (MUL) is a rare growth restriction disorder with multiple organ manifestations caused by genetic defects affecting the TRIM37 protein. A perimyocardial heart disease is the most serious manifestation. Many MUL children appear to suffer from airway obstruction related to infection or exercise, prompting use of inhaled therapies. Asthma medication is continued up to adolescence or even to adulthood due to persisting of symptoms. The pulmonary pathophysiology has previously not been evaluated in any MUL cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty three finnish MUL patients (median age 20 years) were investigated with several lung function tests: spirometry with bronchodilatation test, single\u2010breath diffusing capacity for carbon monoxide, single\u2010breath lung volume measurements with helium dilution, and thoracic gas volume, airway resistance and specific conductance measurements with a body plethysmograph. As MUL typically affects body proportions, all variables were compared with reference values and with predicted values calculated from sitting height.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Total lung capacity and forced vital capacity were markedly reduced (total lung capacity [TLC] and forced vital capacity [FVC], <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001, 51%\u201063% of predicted) and also forced expiratory volume in the first second was reduced (FEV1; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001, 47%\u201057%). No signs of airway obstruction was seen (normal FEV1\/FVC and specific airway conductance SGaw). Diffusing capacity (DLCO) was decreased (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001, 60%\u201067%) but when related to alveolar volume it was increased (DLCO\/VA, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001, 130%\u2010148%). Bronchodilatation suggesting active asthma (FEV1 change \u226512% and \u2265\u200b\u200b200\u2009mL) was found only in one patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MUL patients typically have volume restriction of the lungs, but function of the pulmonary tissue remains intact. Evidence of asthma in lung function testing at adult age is rare.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.24518","type":"journal-article","created":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T05:33:37Z","timestamp":1568093617000},"page":"122-129","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Restriction of lung volumes but normal function of pulmonary tissue in mulibrey nanism"],"prefix":"10.1002","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8399-9697","authenticated-orcid":false,"given":"Johanna","family":"Sivunen","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Children's Hospital University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e4ivi","family":"Piiril\u00e4","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susann","family":"Karlberg","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Children's Hospital University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merja","family":"Kajosaari","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Children's Hospital University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pekka","family":"Valmari","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Lapland Central Hospital Rovaniemi Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markku","family":"Kupari","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Heart and Lung Center University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marita","family":"Lipsanen\u2010Nyman","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Children's Hospital University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannu","family":"Jalanko","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Children's Hospital University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anssi RA","family":"Sovij\u00e4rvi","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology University of Helsinki and Helsinki University Hospital Helsinki 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