Cattaino and Vicario (1999) studied the pictures of Akhenaton, a heretical pharaoh, king of the New Kingdom of Ancient Egypt, (the mummy has not yet been found). Statues and reliefs of him showed an unhealthy man whose body has abnormal features. Cattaino and Vicario (1999) concluded that he may have been affected by myotonic dystrophy. The similarity in the clinical appearance of the members of the royal family suggests a disease with autosomal dominant inheritance. Moreover, Cattaino and Vicario suggested that myotonic dystrophy may have caused the end of the royal bloodline of the Eighteenth Dynasty.

Alfadhli et al. (2004) undertook a study of the CTG trinucleotide repeat number at the (DM) locus in healthy Kuwaitis to explain the apparently rare incidence of the MD disease and as a step toward more extensive study of the disease in the population. The study group consisted of 185 healthy native Kuwaiti individuals representing the 5 Kuwaiti provinces. In the 370 chromosomes analyzed, a total of 17 (CTG)n alleles were found, with a range of 5 to 37 repeats. The (CTG)5 allele was the most frequent single allele (100/370 [27%]), whereas the (CTG)10-13 was the most frequent class of alleles (161/370 [44%]). Using 18 repeats as the cutoff point, X2 analysis showed a statistically significant lower frequency of greater than 18 alleles in the Kuwaiti population compared with the European population (X2=12.7; P<.001). Alfadhli et al. (2004) concluded that the low frequency of DM among Kuwaiti individuals is mostly due to the lower prevalence of the (CTG)>18 alleles in this population.

In 1997, Mor-Cohen el al. conducted a study of the CTG repeat polymorphism in 106 Muslim Arabs from Palestine and 103 Yemenite Jews. Alleles were studied by PCR analysis of the trinucleotide repeat in the dystrophia myotonica gene. The alleles ranged in length from 5-26. The most common allele had 5 repeats in 50.2% of Muslim Arabs. Most of the remaining alleles were in the range of 11-13 repeats (31.8%). Mor-Cohen el al. (1997) suggested that the more frequent occurrence of large CTG repeats in the normal range may represent a greater predisposition to dystrophia myotonica.

[See also: Yemen > Mor-Cohen et al. 1997].

Anwar et al. (1986) reported a rare condition of dystrophia myotonica presenting as a case of infertility in a 35 year old Emirati male. Striking facial feature upon medical investigation were the characteristic appearance of a long and haggard face with bilateral partial ptosis, atrophy of the temporalis and masseter muscles, atrophy of the sternomastoids, and premature frontal baldness. Distal muscular weakness of both upper and lower limbs together with a characteristic myotonia was also noted. Electromyogram revealed increased insertional activities with frequent fibrillations and myotonic discharges. Hormonal assays reflected primary gonadal failure and formal glucose tolerance test showed typical diabetic curve. Testicular biopsy showed marked testicular atrophy.

[Anwar S, Afify H, Hussein A. Dystrophia myotonica presenting as infertility. Emirates Med J 1986; 4:137-9.]

In 1997, Mor-Cohen el al. conducted a study of the CTG repeat polymorphism in 103 Yemenite Jews. Alleles were studied by PCR analysis of the trinucleotide repeat in the dystrophia myotonica gene. The alleles ranged in length from 5-28 repeats in the and the most common allele had 5 repeats in 33.8% of Yemenite Jews. Most of the remaining alleles were in the range of 11-13 repeats (35.7%). Mor-Cohen et al. (1997) indicated that allele distribution in Muslim Arabs from Palestine was significantly different from that in Yemenite Jews using only the 19 repeats as the cutoff point. Mor-Cohen et al. (1997) suggested that the more frequent occurrence of large CTG repeats in the normal range may induce particular susceptibility to expansion to the mutation range in dystrophia myotonica.