Inborn errors of metabolism: New challenges with expanded newborn screening programs

Author(s):  
Nicola Longo
2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ruixue Zhang ◽  
Rong Qiang ◽  
Chengrong Song ◽  
Xiaoping Ma ◽  
Yan Zhang ◽  
...  

AbstractExpanded newborn screening facilitates early identification and intervention of patients with inborn errors of metabolism (IEMs), There is a lack of disease spectrum data for many areas in China. To determine the disease spectrum and genetic characteristics of IEMs in Xi'an city of Shaanxi province in northwest China, 146152 newborns were screening by MSMS from January 2014 to December 2019 and 61 patients were referred to genetic analysis by next generation sequencing (NGS) and validated by Sanger sequencing. Seventy-five newborns and two mothers were diagnosed with IEMs, with an overall incidence of 1:1898 (1:1949 without mothers). There were 35 newborns with amino acidemias (45.45%, 1:4176), 28 newborns with organic acidurias (36.36%, 1:5220), and 12 newborns and two mothers with FAO disorders (18.18%; 1:10439 or 1:12179 without mothers). Phenylketonuria and methylmalonic acidemia were the two most common disorders, accounting for 65.33% (49/75) of all confirmed newborn. Some hotspot mutations were observed for several IEMs, including PAH gene c.728G>A for phenylketonuria; MMACHC gene c.609G>A and c.567dupT, MMUT gene c.323G>A for methylmalonic acidemia and SLC25A13 gene c.852_855del for citrin deficiency. Our study provides effective clinical guidance for the popularization and application of expanded newborn screening, genetic screening, and genetic counseling of IEMs in this region.


Pathology ◽  
2017 ◽  
Vol 49 ◽  
pp. S98 ◽  
Author(s):  
Ching-wan Lam ◽  
Chun-yiu Law ◽  
Chloe Miu Mak ◽  
Wai-kwan Siu ◽  
Hencher Han-Chih Lee ◽  
...  

Author(s):  
Н.Л. Печатникова ◽  
Е.Ю. Захарова ◽  
В.Л. Ижевская

В статье обобщены данные по клинико-экономической оценке программ массового неонатального скрининга на наследственные болезни обмена веществ (НБО). Обсуждаются разные подходы к их клинико-экономической оценке эффективности, влияние внедрения программ расширенного скрининга методом тандемной масс-спектрометрии на бюджет. The article summarizes the data on the clinical and economic evaluation of newborn screening programs for inborn errors of metabolism (IEM). Various approaches to the clinical and economic evaluation of the effectiveness of newborn screening programs, the impact of expanding screening programs by MS/MS on the budget are discussed.


2020 ◽  
Vol 33 (5) ◽  
pp. 639-645
Author(s):  
Nan Yang ◽  
Li-fei Gong ◽  
Jin-qi Zhao ◽  
Hai-he Yang ◽  
Zhi-jun Ma ◽  
...  

AbstractBackgroundIndividual inborn errors of metabolism (IEMs) are rare disorders. Expanded newborn screening for IEMs by tandem mass spectrometry (TMS) is an efficient approach for early diagnosis. Here we provide the newborn screening program for the application of this approach (between July 2014 and March 2019) to the identification of newborns in Beijing at risk of developing a potentially fatal disease.MethodsThe amino acids and acylcarnitines in dried blood spots were analyzed by TMS. Diagnoses of newborns with elevated metabolites were confirmed by gas chromatography-mass spectrometry, biochemical studies, and genetic analysis.ResultsAmong the healthy newborns, 16 metabolic disorder cases were confirmed, giving a total birth prevalence of 1:3666 live births. Organic acidemia (OA) was the most common (9/16 patients; 56%), and methylmalonic acidemia was the most frequently observed OA (7/9 patients; 89%). Five infants were diagnosed with methylmalonic acidemia with homocystinuria type CblC, two with isolated methylmalonic acidemia, one with propionic acidemia, and one with isovaleric acidemia. Four patients (4/16, 25%) were diagnosed with hyperphenylalaninemia. One suffered with medium-chain acyl CoA dehydrogenase deficiency, one with carnitine uptake deficiency, and one with citrin deficiency. Eleven cases underwent genetic analysis. Seventeen mutations in eight IEM-associated genes were identified in 11 confirmed cases. Symptoms were already present within 2 days after birth in 44% (7/16) cases. The infant with propionic acidemia died at 7 days after birth. The other cases received timely diagnosis and treatment, and most of them grew well.ConclusionsThe results illustrate challenges encountered in disease management highlighting the importance of newborn screening for inherited metabolic disorders, which is not yet nationally available in our country. Regional newborn screening programs will provide a better estimation of the incidence of IEM.


2012 ◽  
Vol 59 (1) ◽  
pp. 209-245 ◽  
Author(s):  
Angela Sun ◽  
Christina Lam ◽  
Derek A. Wong

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