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A qualitative or quantitative defect of collagen 6 disorder that covers a wide spectrum of musculoskeletal phenotypes caused by dominant and recessive mutations in the three major collagen VI genes: COL6A1, COL6A2, and COL6A3. These variants lead to a variety of overlapping phenotypes, ranging from severe congenital muscle weakness, hypotonia, torticollis and contractures with loss or non-development of ambulation on one end and childhood to adult onset mild muscle weakness, stiffness, and joint hyperlaxity on the other.
No HPO annotations are available for this condition.
Age of onset: at birth.
The phenotypes associated with collagen VI-related dystrophies (COL6-RDs), once thought to be distinct entities, were clinically defined long before their molecular basis was discovered. The COL6-RDs are now recognized to comprise a continuum of overlapping phenotypes with Bethlem muscular dystrophy at the mild end, Ullrich congenital muscular dystrophy (UCMD) at the severe end, and phenotypes in between that are now collectively categorized within a subgroup called intermediate COL6-RD. These clinical phenotypic designations play an important role in providing a prognosis for future motor and pulmonary function and thus help in improving anticipatory clinical care.
Formal diagnostic criteria for collagen VI-related dystrophies (COL6-RDs) have not been established. The COL6-RDs are caused by a pathogenic variant(s) in COL6A1, COL6A2, or COL6A3 and represent a clinical spectrum including Bethlem muscular dystrophy at the milder end, Ullrich congenital muscular dystrophy (UCMD) at the more severe end, and intermediate COL6-RD, between Bethlem muscular dystrophy and UCMD. Note: Although these phenotypes are now recognized to comprise a continuum of overlapping phenotypes, the clinical designations are useful for providing a prognosis of future motor and pulmonary function and thus help to improve anticipatory clinical care.
No approved treatments are currently available for collagen 6-related myopathy. The disease remains an area of unmet medical need.
Bethlem muscular dystrophy. To establish the extent of disease and needs in an individual diagnosed with Bethlem muscular dystrophy, the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended.
Table 3.
Recommended Evaluations Following Initial Diagnosis in Individuals with Bethlem Muscular Dystrophy
Bethlem muscular dystrophy
Respiratory function surveillance is of utmost importance, since unrecognized respiratory insufficiency is a leading cause of morbidity and mortality. Pulmonary function tests (PFTs) should be performed in both the upright (seated) and supine (lying down) positions at least annually to monitor the FVC. For FVC measurements of 60% predicted or lower, NIV in the form of BiPAP should be planned for and initiated during a polysomnogram – with pressures adjusted while CO2 is monitored – in order to ensure that BiPAP pressures provide adequate ventilation.
No clinical trials have been registered for collagen 6-related myopathy.
33 publications have been identified in PubMed for collagen 6-related myopathy. Research spans Basic Science / Preclinical (48%), Case Report / Case Series (27%), and Epidemiology / Natural History (12%).
Research Type | Count | % of Total |
|---|---|---|
Laboratory research | 16 | 48% |
Data assembled from 3 of 12 sources · Last updated Sep 19, 2026, 6:58 PM UTC
Common questions about collagen 6-related myopathy
The onset of symptoms of Bethlem muscular dystrophy can range from congenital to mid-adulthood. Obvi...
Source: GeneReviews — "Collagen VI-Related Dystrophies"
A COL6-RD should be suspected in individuals with the following , , and findings.
Clinical Findings
Source: GeneReviews — "Collagen VI-Related Dystrophies"
The differential diagnosis of the phenotypes observed in the collagen VI-related dystrophies (COL6-RDs) is discussed in this section. Of note, a normal-to-mildly elevated CK, suggestive findings on muscle MRI, lack of a cardiac phenotype, and normal-to-high intelligence are hallmarks of the COL6-RDs and help in distinguishing them from other disorders.
When joint contractures are subtle or missed, the major differential diagnoses are the limb-girdle muscular dystrophies (LGMDs) (see Limb-Girdle Muscular Dystrophy Overview). When joint contractures are a prominent feature, the major differential diagnoses are those summarized in .
Table 2a.
Disorders with Joint Contractures to Consider in the Differential Diagnosis of Bethlem Muscular Dystrophy
Source: GeneReviews — "Collagen VI-Related Dystrophies"
Biomarker and diagnostic research for collagen 6-related myopathy has been reported in the published literature.
System/Concern | Evaluation | Comment
| • Neuromuscular exam to evaluate degree distribution of muscle weakness its effects on mobility
Exam of joint contractures, esp assessing for asymmetry of Achilles tendon contractures
PT OT assessment
|
| Baseline polysomnogram w/continuous CO2 monitoring | During childhood to assess ventilation during deep sleep
Pulmonary function tests in both upright (seated) supine (lying down) positions w/forced vital capacity monitored closely | Starting at age 5 yrs
| Eval w/cardiologist incl echocardiogram EKG | To evaluate for right-sided heart strain in those w/respiratory insufficiency who are not using NIV or have inadequate BiPAP pressures
| Consultation w/clinical geneticist /or genetic counselor |
BiPAP = bilevel positive airway pressure; NIV = noninvasive ventilation; OT = occupational therapy; PT = physical therapy
Source: GeneReviews — "Collagen VI-Related Dystrophies"
Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for information on clinical studies for a wide range of diseases and conditions. Note: There may not be clinical trials for this disorder.
Source: GeneReviews — "Collagen VI-Related Dystrophies"
View trials for collagen 6-related myopathy
Annual clinical and radiographic assessment of scoliosis
Annual cardiac evaluation with echocardiogram and EKG to evaluate for evidence of right-sided heart strain
Annual neuromuscular assessment by physical therapy and occupational therapy including an evaluation of the distribution of muscle weakness and joint contractures to inform recommendations for stretching regimens and mobility devices. Potential asymmetries of joint contractures are important to assess, given their effect on gait, sitting posture, and overall function.
UCMD / intermediate COL6-RD
Respiratory function surveillance is of utmost importance in UCMD and intermediate COL6-RD, since unrecognized or underrecognized respiratory insufficiency is the leading cause of morbidity and mortality. PFTs should be performed in both the upright (seated) and supine (lying down) positions every six months to monitor the FVC.
Source: GeneReviews — "Collagen VI-Related Dystrophies"
Patient case studies
9 |
27% |
Disease patterns and progression | 4 | 12% |
New treatment approaches | 2 | 6% |
Other research | 1 | 3% |
Testing and diagnosis research | 1 | 3% |
Sureshkumar S (2026). [PMID: 42185044](https://pubmed.ncbi.nlm.nih.gov/42185044/). *Pract Neurol*. [Case Report / Case Series]
Xu W (2026). [PMID: 42083807](https://pubmed.ncbi.nlm.nih.gov/42083807/). *Bioinformatics*. [Basic Science / Preclinical]
López-Márquez A (2026). [PMID: 41287928](https://pubmed.ncbi.nlm.nih.gov/41287928/). *Disease models & mechanisms*. [Basic Science / Preclinical]
Frías M (2025). [PMID: 40602312](https://pubmed.ncbi.nlm.nih.gov/40602312/). *Computers in biology and medicine*. [Case Report / Case Series]
Hu C (2025). [PMID: 40189714](https://pubmed.ncbi.nlm.nih.gov/40189714/). *Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology*. [Basic Science / Preclinical]
Mohassel P (2025). [PMID: 40309777](https://pubmed.ncbi.nlm.nih.gov/40309777/). *The Journal of clinical investigation*. [Basic Science / Preclinical]
Olarewaju BA (2025). [PMID: 41199734](https://pubmed.ncbi.nlm.nih.gov/41199734/). *Acta myologica : myopathies and cardiomyopathies : official journal of the Mediterranean Society of Myology*. [Basic Science / Preclinical]
ElChoueiry M (2025). [PMID: 40792431](https://pubmed.ncbi.nlm.nih.gov/40792431/). *Animal models and experimental medicine*. [Case Report / Case Series]
Herrera Malpica WS (2025). [PMID: 40626679](https://pubmed.ncbi.nlm.nih.gov/40626679/). *Acta myologica : myopathies and cardiomyopathies : official journal of the Mediterranean Society of Myology*. [Case Report / Case Series]
Jiang Y (2025). [PMID: 39764974](https://pubmed.ncbi.nlm.nih.gov/39764974/). *Stem cell research*. [Basic Science / Preclinical]