DNA diagnosis confirms hemoglobin deletion in newborn screen follow-up

New directions in cytogenetic and molecular testing of the neonate

The development of new diagnostic, and hence therapeutic possibilities, has brought the realization that genetic disease is now an integral part of medical practice. Advances in cytogenetic and molecular testing have drastically improved the ability to diagnose with certainty many previously unrecognized conditions. However, this advance in technology does not come without new questions. New tests are not always the most cost effective ones, some have significant diagnostic limitations, and others raise valid ethical issues surrounding the testing of minors. A working understanding of new advances in genetic diagnosis as well as their inherent limitations is crucial for the contemporary practitioner.

Neonatal screening by DNA microarray: spots and chips

Newborn screening (NBS) is a public-health genetic screening programme aimed at early detection and treatment of pre-symptomatic children affected by specific disorders. It currently involves protein-based assays and PCR to confirm abnormal results. We propose that DNA microarray technology might be an improvement over protein assays in the first stage of NBS. This approach has important advantages, such as multiplex analysis, but also has disadvantages, which include a high initial cost and the analysis/storage of large data sets. Determining the optimal technology for NBS will require that technical, public health and ethical considerations are made for the collection and extent of analysis of paediatric genomic data, for privacy and for parental consent.