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Jelassi A, Nasrallah F, Talbi E, Hammami MB, Ghodbane R, Sanhaji H, Feki M, Kaabachi N, Hadj-Taieb S. Spectrum of Organic Aciduria Diseases in Tunisia: A 35-year Retrospective Study. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2024; 12:27-34. [PMID: 38362096 PMCID: PMC10866378 DOI: 10.4103/sjmms.sjmms_437_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/10/2023] [Accepted: 12/24/2023] [Indexed: 02/17/2024]
Abstract
Background Organic aciduria diseases (OADs) occur worldwide, with differences in prevalence and patterns between populations. Objectives To describe the spectrum of OADs identified in Tunisia over a 35-years period. Materials and Methods This retrospective study included patients who were diagnosed with OADs between 1987 and 2022 in the Laboratory of Biochemistry, Rabta Hospital, Tunisia. Organic acids were analyzed using gas chromatography-mass spectrometry. Results A total of 30,670 urine samples were analyzed for OADs, of which 471 were positive for OADs. The estimated incidence of OADs in Tunisia was 6.78 per 100,000 live births. Methylmalonic (n = 146) and propionic (n = 90) acidurias were the most common OADs (estimated incidence: 2.10 and 1.30 per 100,000 live births, respectively). There were 54 cases of L-2-hydroxyglutatric acidurias and 30 cases of pyroglutamic acidurias, which makes it one of the highest in the world. The main clinical features were hypotonia (65%) and feeding difficulties (41%). Age at diagnosis was highly variable, ranging from 1 day to 49 years. Only 27% of the patients were diagnosed within the first month of life. The prevalence of OADs was highest in the Center-East and Southeast regions. Conclusions In Tunisia, OADs are relatively frequent, but there are shortcomings regarding the diagnosis of these disorders. The frequency and health/social impact of these disorders warrant the need for implementing newborn screening programs and suitable patient management.
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Affiliation(s)
- Awatef Jelassi
- Department of Clinical Chemistry, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
- Department of Clinical Chemistry, Laboratory of Biochemistry LR99ES11, Rabta Hospital, Tunis, Tunisia
- Department of Biology, Higher Institute of Biotechnology of Beja, University of Jendouba, Beja, Tunisia
| | - Fahmi Nasrallah
- Department of Clinical Chemistry, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
- Department of Clinical Chemistry, Laboratory of Biochemistry LR99ES11, Rabta Hospital, Tunis, Tunisia
| | - Emna Talbi
- Department of Clinical Chemistry, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
- Department of Clinical Chemistry, Laboratory of Biochemistry LR99ES11, Rabta Hospital, Tunis, Tunisia
| | - Mohamed Bassem Hammami
- Department of Clinical Chemistry, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
- Department of Clinical Chemistry, Laboratory of Biochemistry LR99ES11, Rabta Hospital, Tunis, Tunisia
| | - Rihab Ghodbane
- Department of Clinical Chemistry, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
- Department of Clinical Chemistry, Laboratory of Biochemistry LR99ES11, Rabta Hospital, Tunis, Tunisia
| | - Haifa Sanhaji
- Department of Clinical Chemistry, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
- Department of Clinical Chemistry, Laboratory of Biochemistry LR99ES11, Rabta Hospital, Tunis, Tunisia
| | - Moncef Feki
- Department of Clinical Chemistry, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
- Department of Clinical Chemistry, Laboratory of Biochemistry LR99ES11, Rabta Hospital, Tunis, Tunisia
| | - Naziha Kaabachi
- Department of Clinical Chemistry, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
- Department of Clinical Chemistry, Laboratory of Biochemistry LR99ES11, Rabta Hospital, Tunis, Tunisia
| | - Sameh Hadj-Taieb
- Department of Clinical Chemistry, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
- Department of Clinical Chemistry, Laboratory of Biochemistry LR99ES11, Rabta Hospital, Tunis, Tunisia
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Zelei T, Kovács S, Finn P, Nagy D, Sikirica V, Carlson KB, Vokó Z. Systematic literature review of the epidemiology of glycogen storage disease type 1a. J Pediatr Endocrinol Metab 2023; 36:809-817. [PMID: 37615591 DOI: 10.1515/jpem-2023-0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/27/2023] [Indexed: 08/25/2023]
Abstract
Glycogen storage disease (GSD) type 1a is an inherited autosomal recessive metabolic disease caused by a deficiency in glucose-6-phosphatase activity. The objectives of this research were to systematically review the published literature on the epidemiology of GSD 1a and to assess the performance of reported epidemiology measures in a simulation model. In this systematic literature review 2,539 record titles and abstracts were screened. Of these, only 11 studies contained relevant data on GSD 1a disease epidemiology. Reported disease frequency ranged from 0.085/100,000 to 10.3/100,000 newborns when considering all the GSD literature. When this was narrowed to GSD 1 and GSD 1a, the range was tightened to 0.25-3.02/100,000 and 0.085-4.9/100,000 newborns, respectively. Most of the identified studies counted the number of diagnoses in a defined period and related to the number of births in the same (Dx method) or different time period (DoB method). The simulation model results indicate that in most of the situations, the Dx method provides a closer estimate to the true disease incidence than the DoB method. Despite the scarcity of epidemiology data, the results of this systematic review strongly support that GSD 1a and its parent disease groups (GSD and GSD 1) are rare diseases.
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Affiliation(s)
- Tamás Zelei
- Syreon Research Institute, Budapest, Hungary
| | | | | | - Dávid Nagy
- Syreon Research Institute, Budapest, Hungary
| | | | | | - Zoltán Vokó
- Syreon Research Institute, Budapest, Hungary
- Semmelweis University, Budapest, Hungary
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Zhang Y, Peng C, Wang L, Chen S, Wang J, Tian Z, Wang C, Chen X, Zhu S, Zhang GF, Wang Y. Prevalence of propionic acidemia in China. Orphanet J Rare Dis 2023; 18:281. [PMID: 37689673 PMCID: PMC10493020 DOI: 10.1186/s13023-023-02898-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 08/31/2023] [Indexed: 09/11/2023] Open
Abstract
Propionic acidemia (PA) is a rare autosomal recessive congenital disease caused by mutations in the PCCA or PCCB genes. Elevated propionylcarnitine, 2-methylcitric acid (2MCA), propionylglycine, glycine and 3-hydroxypropionate can be used to diagnose PA. Early-onset PA can lead to acute deterioration, metabolic acidosis, and hyperammonemia shortly after birth, which can result in high mortality and disability. Late-onset cases of PA have a more heterogeneous clinical spectra, including growth retardation, intellectual disability, seizures, basal ganglia lesions, pancreatitis, cardiomyopathy, arrhythmias, adaptive immune defects, rhabdomyolysis, optic atrophy, hearing loss, premature ovarian failure, and chronic kidney disease. Timely and accurate diagnosis and appropriate treatment are crucial to saving patients' lives and improving their prognosis. Recently, the number of reported PA cases in China has increased due to advanced diagnostic techniques and increased research attention. However, an overview of PA prevalence in China is lacking. Therefore, this review provides an overview of recent advances in the pathogenesis, diagnostic strategies, and treatment of PA, including epidemiological data on PA in China. The most frequent variants among Chinese PA patients are c.2002G > A in PCCA and c.1301C > T in PCCB, which are often associated with severe clinical symptoms. At present, liver transplantation from a living (heterozygous parental) donor is a better option for treating PA in China, especially for those exhibiting a severe metabolic phenotype and/or end-organ dysfunction. However, a comprehensive risk-benefit analysis should be conducted as an integral part of the decision-making process. This review will provide valuable information for the medical care of Chinese patients with PA.
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Affiliation(s)
- Yixing Zhang
- School of Clinical Medicine, Jining Medical University, Shandong, 272067, China
| | - Chuwen Peng
- School of Clinical Medicine, Jining Medical University, Shandong, 272067, China
| | - Lifang Wang
- School of Clinical Medicine, Jining Medical University, Shandong, 272067, China
| | - Sitong Chen
- School of Clinical Medicine, Jining Medical University, Shandong, 272067, China
| | - Junwei Wang
- School of Clinical Medicine, Jining Medical University, Shandong, 272067, China
| | - Ziheng Tian
- School of Clinical Medicine, Jining Medical University, Shandong, 272067, China
| | - Chuangong Wang
- School of Basic Medicine, Jining Medical University, 133 Hehua Road, Shandong, 272067, China
- Jining Key Laboratory of Pharmacology, Jining Medical University, Shandong, 272067, China
| | - Xiaoxin Chen
- Surgical Research Lab, Department of Surgery, Cooper University Hospital, Camden, NJ, 08103, USA
- Coriell Institute for Medical Research, Camden, NJ, 08103, USA
- MD Anderson Cancer Center at Cooper, Camden, NJ, 08103, USA
- Cooper Medical School of Rowan University, Camden, NJ, 08103, USA
| | - Suhong Zhu
- School of Basic Medicine, Jining Medical University, 133 Hehua Road, Shandong, 272067, China.
- Jining Key Laboratory of Pharmacology, Jining Medical University, Shandong, 272067, China.
| | - Guo-Fang Zhang
- Duke Molecular Physiology Institute and Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Carmichael Building 48-203, 300 North Duke Street, Durham, NC, 27701, USA.
- Department of Medicine, Division of Endocrinology, Metabolism Nutrition, Duke University Medical Center, Durham, NC, 27701, USA.
| | - You Wang
- School of Basic Medicine, Jining Medical University, 133 Hehua Road, Shandong, 272067, China.
- Jining Key Laboratory of Pharmacology, Jining Medical University, Shandong, 272067, China.
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Jafari M, Karami F, Setoodeh A, Rahmanifar A, Bagherian H, Alaei MR, Rohani F, Zeinali S. Identification of Novel Mutations in the MMAA and MUT Genes among Methylmalonic Aciduria Families. IRANIAN BIOMEDICAL JOURNAL 2023; 27:397-403. [PMID: 38158783 PMCID: PMC10826912 DOI: 10.61186/ibj.3782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 02/08/2023] [Indexed: 01/03/2024]
Abstract
Background Methylmalonic aciduria is a rare inherited metabolic disorder with autosomal recessive inheritance pattern. There are still MMA patients without known mutations in the responsible genes. This study aimed to identify mutations in Iranian MMA families using autozygosity mapping and NGS. Methods Multiplex PCR was performed on DNAs isolated from 12 unrelated MMA patients and their family members using 19 STR markers flanking MUT, MMAA, and MMAB genes, followed by Sanger sequencing. WES was carried out in the patients with no mutation. Results Haplotype analysis and Sanger sequencing revealed two novel, mutations, A252Vf*5 and G87R, within the MMAA and MUT genes, respectively. Three patients showed no mutations in either autozygosity mapping or NGS analysis. Conclusion High-frequency mutations within exons 2 and 3 of MUT gene and exon 7 of MMAB gene are consistent with the global expected frequency of genetic variations among MMA patients.
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Affiliation(s)
- Mahboobeh Jafari
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
- These authors were contributed equally in the present work
| | - Fatemeh Karami
- Department of Medical Genetics, Applied Biophotonics Research Center, Science and Research Branch, Islamic Azad University, Tehran, Iran
- These authors were contributed equally in the present work
| | - Aria Setoodeh
- Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Rahmanifar
- Clinical and Research Unit, Iranian National Society for the Study of Inborn Errors of Metabolism, Tehran, Iran
| | | | - Mohammad Reza Alaei
- Department of Pediatric Endocrinology and Metabolism, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Rohani
- Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Science, Tehran, Iran
| | - Sirous Zeinali
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
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Elsayed O, Al‐Shamsi A. Mutation spectrum of non-syndromic hearing loss in the UAE, a retrospective cohort study and literature review. Mol Genet Genomic Med 2022; 10:e2052. [PMID: 36056583 PMCID: PMC9651598 DOI: 10.1002/mgg3.2052] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/23/2022] [Accepted: 08/15/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Hearing loss (HL) is a heterogeneous condition that causes partial or complete hearing impairment. Hundreds of variants in >60 genes have been reported to be associated with Hereditary HL (HHL), variants of the GJB2 gene are the most common cause of congenital SNHL, with >100 variants reported. The HHL prevalence is thought to be high in the Arab population; however, the genetic epidemiology of HHL among Emirati populations is understudied. AIMS To shed light on the mutational spectrum of NSHL in Emirati patients seen in the genetic clinic over 10 years and to capture founder mutation(s) if any were identified. METHODS Retrospective chart review of all Emirati patients assessed by clinical geneticists due to NSHL during the period between January 2010 to December 2020. Genetic tests were done based on clinical phenotypes of the patient and family history including targeted mutation testing, next-generation sequencing, or whole-exome sequencing (solo or trio). The authors did literature reviews using PubMed for all previously reported articles related to NSHL genes from UAE. RESULTS A total of 162 patients with HL, were evaluated during the period between January 2010 to December 2020. There were 82 patients with NSHL, and only 72 patients who completed the genetic evaluations were included in this retrospective study. Among the studied group, 42 (51.2%) were males and 40 (48.78%) were females. The youngest patient was 2 years old and the oldest patient was 50 years old. Consanguinity was documented in 76 patients (92.68%). A total of 14 mutations reported here are novel (23/72 i.e., 31.9%). Twelve missense mutations, 6 nonsense mutations, 6 frameshift mutations, 2 in-frame deletion mutations, and 1 splice site mutation was found. Variants in the GJB2 gene are the most commonly identified cause of NSHL, with c.35delG being the most followed by c.506G > A. The second commonly found variant is c.934C > G (p.Arg312Gly) in the CDC14A gene, found in 9 patients. This was followed by variants in OTOF and SLC26A4 genes, found in 8 patients, respectively. Chromosomal microdeletions encompassing genes causing NSHL were found in 3 patients. No mitochondrial mutations were found in this study group. A total of 11 previous reports about Emirati patients with NSHL were reviewed, with a total of 35 patients. CONCLUSION Emirati patients with NSHL have several mutations, most notably missense mutations. Novel mutations are worth further testing and represent the area for future researches.
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Affiliation(s)
- Omnia Elsayed
- Pediatrics DepartmentTawam HospitalAl AinUnited Arab Emirates
| | - Aisha Al‐Shamsi
- Genetic Division, Pediatrics DepartmentTawam HospitalAl AinUnited Arab Emirates
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El-Naggari MA, Rady M, Althihli K. Transient Insulin Resistance in Propionic Acidaemia: Knowing is half the battle. Sultan Qaboos Univ Med J 2021; 21:648-651. [PMID: 34888089 PMCID: PMC8631204 DOI: 10.18295/squmj.4.2021.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/06/2020] [Accepted: 11/24/2020] [Indexed: 12/04/2022] Open
Abstract
Propionic acidaemia (PPA) is a disorder of amino acid and odd-chain fatty acid metabolism. Hypoglycaemia is a more commonly described finding rather than hyperglycaemia during metabolic decompensation of PPA. There is a high mortality rate in patients with organic acidaemias having severe insulin-resistant hyperglycaemia. We report a nine-month-old boy with PPA who was admitted to tertiary care hospital in Muscat, Oman, in 2018 with metabolic decompensation, persistent hyperglycaemia and transient insulin resistance. Hyperglycaemia did not respond to high insulin infusion. Plasma glucose only improved when glucose infusion rate (GIR) reached 7 mg/kg/min. The patient has full recovery and was discharged, with follow up plan. It is important to balance the GIR to achieve the targeted insulin level, beyond which the risks of hyperglycaemia start to outweigh the potential anabolic benefits of additional insulin secretion. Timely clinical attention should be given to achieve adequate caloric delivery through alternative sources other than high GIR to permit better glycaemic control, especially when insulin-resistant hyperglycaemia is present.
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Affiliation(s)
| | | | - Khalid Althihli
- Metabolic & Genetic Disease, Sultan Qaboos University Hospital, Muscat, Oman
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Sakrani NF, Kul Hasan H, Ibrahim A, Al Jubeh J, Al Teneiji A. Novel mutation causing propionic acidemia associated with unexplained autoimmune thyrotoxicosis. Mol Genet Metab Rep 2021; 29:100806. [PMID: 34646737 PMCID: PMC8498454 DOI: 10.1016/j.ymgmr.2021.100806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 11/30/2022] Open
Abstract
Propionic acidemia (PA) is a rare autosomal recessive inborn error of metabolism (IEM) with relatively higher prevalence in the United Arab Emirates (UAE). Absence of propionyl-CoA carboxylase (PCC) enzyme classically leads to acute decompensation in the early neonatal period. We report a novel homozygous frameshift variant c.2158_2159insT; p.Glu720Valfs*14 (NM_000282.3) in the last exon of the PCCA gene which led to a severe presentation of PA in a newborn Emirati female. Uniquely the diagnosis remained unclear since newborn screening revealed an isolated elevation in plasma proprionylcarnitine (C3) while urinary organic acids remained persistently negative for the classic biochemical abnormalities even during the period of critical illness. Additionally, the patient had an unexplained diagnosis of neonatal thyrotoxicosis. This case explores possible underlying causes through an extensive literature search. To date, there have been no similar reported cases in existing literature. Propionic acidemia Novel mutation Autoimmune thyrotoxicosis (maternal serology negative)
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Key Words
- AA, Amino Acids
- C3, proprionylcarnitine
- FT3/FT4, Free T3/Free T4
- G-CSF, growth colony stimulating factor
- HD, hemodialysis
- Hyperammonemia
- Hyperthyroidism
- IEM, Inborn Errors of Metabolism
- MMA, methlymalonic acid
- MRI, Magnetic Resonance Imaging
- Metabolic acidosis
- Neonate
- OA, Organic Acids
- PA, Propionic Acidema
- PCC, Propionyl-CoA Carboxylase
- PICU, pediatric intensive care unit
- Propionic acidemia
- TPN, Total parenteral nutrition
- TPO, Thyroid Peroxidase
- TRAB, Thyroid Receptor Antibodies
- TSH, Thyroid Stimulating Hormone
- TSI, Thyroid Stimulating Immunoglobulins
- Thyrotoxicosis
- UAE, United Arab Emirates
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Affiliation(s)
- Nida Fatima Sakrani
- General Pediatrics, Department of Pediatrics, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Hala Kul Hasan
- General Pediatrics, Department of Pediatrics, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Ahmed Ibrahim
- Division of Pediatric Endocrinology, Department of Pediatrics, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Jamal Al Jubeh
- Division of Pediatric Endocrinology, Department of Pediatrics, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Amal Al Teneiji
- Division of Metabolic and Genetics, Department of Pediatrics, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
- Corresponding author at: Division of Metabolic and Genetics, Department of Pediatrics, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
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Saleh S, Beyyumi E, Al Kaabi A, Hertecant J, Barakat D, Al Dhaheri NS, Al-Gazali L, Al Shamsi A. Spectrum of neuro-genetic disorders in the United Arab Emirates national population. Clin Genet 2021; 100:573-600. [PMID: 34374989 DOI: 10.1111/cge.14044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/31/2021] [Accepted: 08/06/2021] [Indexed: 11/27/2022]
Abstract
Clinical and molecular characterization of neuro-genetic disorders among UAE national patients seen in the Genetic Clinic at Tawam hospital over a period of 3 years. A retrospective chart review of all Emirati patients assessed by clinical geneticists due to neuro-genetic disorders including global developmental delay, ASD, ID, ADHD, and epilepsy in combination with abnormalities of other organ systems. Each patient had proper assessment including detailed history, three-generation family history, developmental history and detailed physical examination looking for other system involvement. Hearing test and ophthalmological examination were performed when needed. Magnetic resonance imaging (MRI) of the brain, echocardiogram, and renal ultrasound were pursued as indicated. Detailed psychological evaluation and psychometric assessment were done when indicated. The review was done for a period between January 2018 and December 2020. Genetic investigations included chromosome karyotype, FISH study, metabolic/biochemical tests, chromosome microarray, gene sequencing, targeted mutation testing, trio whole exome and trio genome sequencing. A total of 644 patients with developmental delay, ID, learning difficulty, ASD, ADHD, or NNDs, were seen in genetic clinic from January 2018 to December 2020. A total of 506 patients were included in this review, all completed the genetic evaluations during the study period. There were 398 (61.8%) males and 246 (38.2%) females, with a ratio of 1.6:1. Positive family history of NDD was documented in 132 families, while 115 families had negative history and family history was unknown/unclear in the remaining. Fifty seven (11.26% [57/506]) patients had positive microarray results. Hundred ninety seven (38.9% [197/506]) patients had positive molecular testing. Genetic disorders were found in 133 (67.5% [133/197]) and inborn errors of metabolism were found in 42 (21.3% [42/197]). Consanguinity was documented in 139 patients with positive molecular diagnoses (139/197, 70.5%). Sixty nine (35% [69/197]) patients had autosomal dominant disorders, majority were De Novo (84%). Ninety-five (48% [95/197]) patients had autosomal recessive diseases, 40 mutations involved inborn errors of metabolism and 50 mutations involved genetic disorders. Pathogenic variants causing both autosomal dominant and recessive disorders were found in 98 patients (49.7% [98/197]), likely pathogenic variants causing both autosomal dominant and recessive disorders were found in 66 patients (33.5% [66/197]). X-linked related disorders were found in 10 patients (5% [10/197]). Mitochondrial mutation was found in one patient. Novel mutations were found in 76 patients (76/197 i.e., 38.56%). Twenty two patients had variants of unknown significant. The remaining 252 studied patients (252/506 i.e., 49.8%), remained undiagnosed. This study shows that neuro-genetic disorders in the UAE are very heterogeneous at clinical and molecular levels. Using microarray, WES and WGS a diagnosis was reached in 50% of the patients while no diagnosis was reached in other half of the studied patients. It is possible that some mutations were missed by WGS and WES. However, it is also possible that many of disorders in UAE population are novel and the causative mutation is not yet discovered. More researches need to be done in this population to uncover the molecular basis of these disorders.
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Affiliation(s)
- Sirine Saleh
- Pediatrics Department, Tawam Hospital, Al Ain, United Arab Emirates
| | - Ela Beyyumi
- Pediatrics Department, Tawam Hospital, Al Ain, United Arab Emirates
| | - Aysha Al Kaabi
- Pediatrics Department, Tawam Hospital, Al Ain, United Arab Emirates
| | - Jozef Hertecant
- Genetic Division, Pediatrics Department, Tawam Hospital, Al Ain, United Arab Emirates
| | - Doaa Barakat
- Psychiatry Department, Behvioral Sciences Institute, Al Ain Hospital, Al Ain, United Arab Emirates
| | - Noura S Al Dhaheri
- Department of Pediatrics & Department of Genetics & Genomics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Lihadh Al-Gazali
- Departments of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Aisha Al Shamsi
- Genetic Division, Pediatrics Department, Tawam Hospital, Al Ain, United Arab Emirates
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Alsalamah AK, Khan AO. Asymptomatic retinal dysfunction in alpha-methylacyl-CoA racemase deficiency. Mol Vis 2021; 27:396-402. [PMID: 34267495 PMCID: PMC8254661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 06/29/2021] [Indexed: 11/03/2022] Open
Abstract
Purpose Alpha-methylacyl-CoA racemase (AMACR) deficiency is a peroxisomal disorder due to biallelic mutations in AMACR. At least 13 genetically confirmed patients have been reported to date. Seven had obvious pigmentary retinopathy; however, for the other six, no retinal phenotype was mentioned. The purpose of this report is to document subtle retinal findings in an additional affected family. Methods Retrospective case series (three affected siblings and their unaffected parents). Results Three Arab siblings (16, 19, and 22 years old) with prior juvenile cholelithiasis had been diagnosed with AMACR deficiency based on biochemical analysis, whole exome sequencing, and confirmatory segregation analysis (AMACR NM_001167595.1: c.877T>C; p.C293R). For all three, there were no visual complaints, but retinal multimodal imaging and electroretinography suggested subtle retinal dysfunction. Conclusions Retinal dysfunction is a parameter that should be measured in patients with known or suspected AMACR deficiency even in the absence of visual symptoms. This may be helpful with clinical diagnosis and monitoring response to dietary interventions.
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Affiliation(s)
- Abrar K. Alsalamah
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- Vitreoretinal and Uveitis Divisions, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Arif O. Khan
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western University, Cleveland, OH
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10
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Elabd HSA, Bastaki F, Khalifa M. Homozygous Novel Variants in the Glycine Decarboxylase Gene Associated with Nonketotic Hyperglycinemia in a Distinct Population. J Pediatr Genet 2021; 12:23-31. [PMID: 36684550 PMCID: PMC9848757 DOI: 10.1055/s-0041-1729741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/21/2021] [Indexed: 01/25/2023]
Abstract
Glycine encephalopathy (GE), also known as nonketotic hyperglycinemia (NKH) is an autosomal recessive disorder due to a primary defect in the glycine cleavage enzyme system. It is characterized by elevated levels of glycine in the plasma and cerebrospinal fluid (CSF) and increased CSF to plasma glycine ratio. Mutations in three genes of the mitochondrial glycine cleavage system have been found to cause NKH. Most patients have a mutation in the GLDC . In this report, we present five new patients from Middle Eastern families with NKH. They were all born to consanguineous parents and two of them have family history of similarly affected sibling(s). All patients presented with neonatal encephalopathy associated with seizures. Their diagnoses were suspected clinically and confirmed biochemically. DNA sequence analysis of the five patients revealed five different pathogenic or likely pathogenic variants in the GLDC . Three were missense variants (c.2675C > T; p.Ala892Val), (c.2512A > G; p.Asn838Asp), and (c.2943A > C; p.Lys981Asn); one was an intronic missense variant (c.1402-2A > T) leading to an exonic deletion, and one was a deletion of 42 amino acids (c.1927-?_2052 + ?del.) All variants were novel and homozygous. The pathogenicity of these variants was determined according to the American College of Medical Genetics (ACMG) variant classification and in silico analysis. Another novel homozygous variant (c.1384C > G; p.Leu462Val) was detected, which was classified as likely benign. The novel variants identified in the GLDC in these patients underlie the pathogenesis of NKH, specifically for the Middle Eastern population. This expands the mutation spectrum of NKH to include a distinct ethnic population that has not been studied before.
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Affiliation(s)
- Heba Salah Abdelkhalek Elabd
- Department of Pediatrics Genetics, Latifa Women and Children Hospital, Dubai Health Authority, Dubai, United Arab Emirates,Department of Genetics, Faculty of Medicine, Ain Shams University, Cairo, Egypt,Address for correspondence Heba Salah Abdelkhalek Elabd, MD Latifa Women and Children HospitalOud Metha Road, Al Jadaf, Dubai, PO Box 9115United Arab Emirates
| | - Fatma Bastaki
- Department of Pediatrics Genetics, Latifa Women and Children Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Mohamed Khalifa
- Department of Pediatrics Genetics, Latifa Women and Children Hospital, Dubai Health Authority, Dubai, United Arab Emirates
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Wu F, Fan SJ, Zhou XH. Neonatal isovaleric acidemia in China: A case report and review of literature. World J Clin Cases 2021; 9:436-444. [PMID: 33521113 PMCID: PMC7812894 DOI: 10.12998/wjcc.v9.i2.436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/07/2020] [Accepted: 11/21/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Isovaleric acidemia (IVA) is a rare autosomal recessive inherited organic acidemia caused by a genetic deficiency of isovaleryl-CoA dehydrogenase (IVD). Its morbidity is low, but mortality is high. There is no effective cure for this disease. Early identification of IVA using clinical features can significantly slow disease progression and reduce mortality. Here we report a Chinese neonate with two mutations of IVD and share valuable information on this disease.
CASE SUMMARY A 12-day-old male neonate with “poor response for 1 d and repeated convulsions accompanied by high muscle tension for 6 h” was hospitalized. The patient was the first child of nonconsanguineous ethnic Chinese parents. He was delivered by cesarean section due to breech position at 39 + 1 wk of gestation with a birth weight of 3.27 kg. Initially, he suffered from dyspnea and rhinobyon, and at 10 d after birth the patient suddenly developed poor feeding, low response, lethargy and seizures. Organic acid analysis of blood and urine by tandem mass spectrometry and gas chromatography mass spectrometry showed extremely high concentrations of isovaleryl glycine. The patient had an acute episode of IVA causing severe metabolic stress and eventually died.
CONCLUSION A new case of an IVA patient carrying c.1193G>A (p.Arg398Gln) and c.1208A>G (p.Try403Cys) mutations is reported in China.
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Affiliation(s)
- Fang Wu
- Department of Neonatalogy, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
| | - Shu-Juan Fan
- Department of Neonatalogy, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
| | - Xi-Hui Zhou
- Department of Neonatalogy, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
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12
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Late-onset MADD in Yemen caused by a novel ETFDH mutation misdiagnosed as ADEM. Mult Scler Relat Disord 2020; 48:102689. [PMID: 33383363 DOI: 10.1016/j.msard.2020.102689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/16/2020] [Accepted: 12/10/2020] [Indexed: 01/09/2023]
Abstract
We report a case of late-onset multiple acyl-CoA dehydrogenase deficiency (MADD) with recurrent abdominal pain, vomiting, and impaired consciousness as the initial symptoms in Yemen; the case showed distinctive characteristics from those of Asian or Caucasian patients. Initially, he was misdiagnosed with pancreatitis, acute disseminated encephalomyelitis(ADEM), and fatty liver. Final diagnosis was further confirmed by electromyography, muscle biopsy, uric organic acid analysis, and a novel missense mutation in exon 7 (c.807A>C) of ETFDH was identified by next-generation sequencing. To our knowledge, we report this mutation in an adult MADD patient as well as late-onset MADD in a Middle East country for the first time. MADD is characterised by varied genotypes and broad spectrum of clinical manifestations among different populations and ages, which requires more attention and awareness in the clinic.
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Alsamri MT, Alabdouli A, Alkalbani AM, Iram D, Antony P, Vijayan R, Souid AK. Genetic variants in children with chronic respiratory diseases. Pediatr Pulmonol 2020; 55:2389-2401. [PMID: 32662942 DOI: 10.1002/ppul.24908] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 06/15/2020] [Indexed: 01/20/2023]
Abstract
Founder mutations and autosomal recessive (AR) disorders are common in the Arabian Peninsula due to frequent consanguineous marriages. As a result, the pulmonary service at Tawam Hospital (Al Ain, UAE) routinely requests genetic testing for children with persistent (unexplained) respiratory problems. The main purpose of this report was to underscore the usefulness of these tests. Ten children with severe respiratory diseases due to complex genetic findings are described here. Forty-one variants (six novel) were detected, averaging four per patient (range: 1-9). Seven (17%) variants were homozygous and 34 (83%) heterozygous; some variants were known to show monoallelic expression. Using binomial probability distribution, the fetal-risk for having AR disorder(s) as a function of the number of shared variants by a couple ranged from 0.25 (having one shared variant) to 0.9249 (having nine shared variants). In cultures where increased size of homozygous genomic segments is common, children often have multiple variants that could cause complex clinical phenotypes. Identifying pathogenic variants assists in clinical care, family counseling, and disease prevention through genetic screening.
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Affiliation(s)
| | - Amnah Alabdouli
- Department of Pediatrics, Tawam Hospital, Al Ain, United Arab Emirates
| | - Alia M Alkalbani
- Department of Pediatrics, Tawam Hospital, Al Ain, United Arab Emirates
| | - Durdana Iram
- Department of Pediatrics, Tawam Hospital, Al Ain, United Arab Emirates
| | - Priya Antony
- Department of Biology, College of Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Ranjit Vijayan
- Department of Biology, College of Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Abdul-Kader Souid
- Department of Pediatrics, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
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Aljasmi FA, Vijayan R, Sudalaimuthuasari N, Souid AK, Karuvantevida N, Almaskari R, Mohammed Abdul Kader H, Kundu B, Michel Hazzouri K, Amiri KMA. Genomic Landscape of the Mitochondrial Genome in the United Arab Emirates Native Population. Genes (Basel) 2020; 11:genes11080876. [PMID: 32752197 PMCID: PMC7464197 DOI: 10.3390/genes11080876] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 07/26/2020] [Accepted: 07/28/2020] [Indexed: 11/19/2022] Open
Abstract
In order to assess the genomic landscape of the United Arab Emirates (UAE) mitogenome, we sequenced and analyzed the complete genomes of 232 Emirate females mitochondrial DNA (mtDNA) within and compared those to Africa. We investigated the prevalence of haplogroups, genetic variation, heteroplasmy, and demography among the UAE native population with diverse ethnicity and relatively high degree of consanguinity. We identified 968 mtDNA variants and high-resolution 15 haplogroups. Our results show that the UAE population received enough gene flow from Africa represented by the haplogroups L, U6, and M1, and that 16.8% of the population has an eastern provenance, depicted by the U haplogroup and the M Indian haplogroup (12%), whereas western Eurasian and Asian haplogroups (R, J, and K) represent 11 to 15%. Interestingly, we found an ancient migration present through the descendant of L (N1 and X) and other sub-haplogroups (L2a1d and L4) and (L3x1b), which is one of the oldest evolutionary histories outside of Africa. Our demographic analysis shows no population structure among populations, with low diversity and no population differentiation. In addition, we show that the transmission of mtDNA in the UAE population is under purifying selection with hints of diversifying selection on ATP8 gene. Last, our results show a population bottleneck, which coincides with the Western European contact (1400 ybp). Our study of the UAE mitogenomes suggest that several maternal lineage migratory episodes liking African–Asian corridors occurred since the first modern human emerges out of Africa.
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Affiliation(s)
- Fatma A Aljasmi
- Pediatric Department, United Arab Emirates University, Al Ain, Abu Dhabi 15551, UAE
| | - Ranjit Vijayan
- Biology Department, United Arab Emirates University, Al Ain, Abu Dhabi 15551, UAE
| | | | - Abdul-Kader Souid
- Pediatric Department, United Arab Emirates University, Al Ain, Abu Dhabi 15551, UAE
| | | | - Raja Almaskari
- Biology Department, United Arab Emirates University, Al Ain, Abu Dhabi 15551, UAE
| | | | - Biduth Kundu
- Biology Department, United Arab Emirates University, Al Ain, Abu Dhabi 15551, UAE
| | - Khaled Michel Hazzouri
- Khalifa Center for Genetic Engineering and Biotechnology, United Arab Emirates University, Al Ain, Abu Dhabi 15551, UAE
| | - Khaled M A Amiri
- Biology Department, United Arab Emirates University, Al Ain, Abu Dhabi 15551, UAE
- Khalifa Center for Genetic Engineering and Biotechnology, United Arab Emirates University, Al Ain, Abu Dhabi 15551, UAE
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[DGUOK-related mitochondrial DNA depletion syndrome: a case report and literature review]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020; 22. [PMID: 32204766 PMCID: PMC7389589 DOI: 10.7499/j.issn.1008-8830.2020.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A boy, aged 4 months, had the major clinical manifestations of prolonged jaundice and hepatomegaly. Multiple biochemical tests revealed abnormal liver function along with elevated alpha-fetoprotein and lactate. Genetic analysis confirmed that the boy had the mutations of c.589C>T(p.Gln197Ter) and c.687G>C(p.Trp229Cys) in the DGUOK gene, both of which were novel mutations and were determined to be pathogenic and likely pathogenic respectively, by a variety of bioinformatics tools and the ACMG standard. Therefore, the boy was confirmed to have DGUOK-related mitochondrial DNA depletion syndrome. Literature review showed that onset of liver disease in infancy was the main clinical feature of this disease, and some children presented with nervous system manifestations. Abnormal laboratory results included abnormal liver function, increases in blood lactate, serum ferritin and alpha-fetoprotein, and hypoglycemia. Such children had marked heterogeneity of DGUOK gene mutations, with missense mutations as the most common type. This disease tended to have a poor prognosis, and 79.6% of the children died before the age of 3 years.
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16
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Jiang YZ, Shi Y, Shi Y, Gan LX, Kong YY, Zhu ZJ, Wang HB, Sun LY. Methylmalonic and propionic acidemia among hospitalized pediatric patients: a nationwide report. Orphanet J Rare Dis 2019; 14:292. [PMID: 31842933 PMCID: PMC6915987 DOI: 10.1186/s13023-019-1268-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 12/02/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Methylmalonic acidemia (MMA) and propionic acidemia (PA) are two kinds of diseases caused by inborn errors of metabolism. So far, the epidemiological data on them are limited in China. The aim of our study is to investigate the proportion and characteristics of hospitalized pediatric patients with MMA and PA in China. METHODS The data in this study were obtained from the Hospital Quality Monitoring System, a national inpatient database in China, with information on the patients hospitalized during the period from 2013 to 2017. We identified the data related to the patients who were under 18 years old and were diagnosed with MMA/PA, and extracted the information on demographic characteristics, hospital location, total cost and other related clinical presentations from the data. RESULTS Among all hospitalized pediatric patients with liver diseases, there were increasing trends in the proportion of individuals diagnosed with MMA or PA during the period from 2013 (0.76% for MMA; 0.13% for PA) to 2017 (1.61% for MMA; 0.32% for PA). For both MMA and PA, children under 2-year-old accounted for the highest proportion. The median of total cost per hospitalization was relatively high (RMB 7388.53 for MMA; RMB 4999.66 for PA). Moreover, most patients hospitalized in tertiary class A hospitals (MMA: 80.96%, PA: 76.21%); and a majority of pediatric patients admitted in the hospitals in Shanghai and Beijing are from outside districts. Manifestations of nervous system-related symptoms, and metabolic acidosis or anemia in laboratory findings were more common during hospitalization. CONCLUSIONS The study is the first nationwide one in providing epidemiological and clinical information on hospitalized pediatric patients with MMA/PA. An increasing hospitalization with various presentations and a heavy financial burden were observed. In addition, geographically, the medical resources in China have been unevenly distributed.
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Affiliation(s)
- Yi-Zhou Jiang
- National Clinical Research Centre for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, 95# Yong-an Road, Xi Cheng District, Beijing, 100050, China
| | - Yu Shi
- National Clinical Research Centre for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, 95# Yong-an Road, Xi Cheng District, Beijing, 100050, China
| | - Ying Shi
- China Standard Medical Information Research Centre, Shenzhen, Guangdong, China
| | - Lan-Xia Gan
- China Standard Medical Information Research Centre, Shenzhen, Guangdong, China
| | - Yuan-Yuan Kong
- National Clinical Research Centre for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, 95# Yong-an Road, Xi Cheng District, Beijing, 100050, China
| | - Zhi-Jun Zhu
- National Clinical Research Centre for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, 95# Yong-an Road, Xi Cheng District, Beijing, 100050, China.
| | - Hai-Bo Wang
- Clinical Trial Unit, Precision Medicine Institute, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, No.58, Zhong Shan Er Lu, Guangzhou, 510080, China.
| | - Li-Ying Sun
- National Clinical Research Centre for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, 95# Yong-an Road, Xi Cheng District, Beijing, 100050, China.
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17
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Abdelkreem E, Harijan RK, Yamaguchi S, Wierenga RK, Fukao T. Mutation update on ACAT1 variants associated with mitochondrial acetoacetyl-CoA thiolase (T2) deficiency. Hum Mutat 2019; 40:1641-1663. [PMID: 31268215 PMCID: PMC6790690 DOI: 10.1002/humu.23831] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 05/27/2019] [Accepted: 05/31/2019] [Indexed: 02/05/2023]
Abstract
Mitochondrial acetoacetyl‐CoA thiolase (T2, encoded by the ACAT1 gene) deficiency is an inherited disorder of ketone body and isoleucine metabolism. It typically manifests with episodic ketoacidosis. The presence of isoleucine‐derived metabolites is the key marker for biochemical diagnosis. To date, 105 ACAT1 variants have been reported in 149 T2‐deficient patients. The 56 disease‐associated missense ACAT1 variants have been mapped onto the crystal structure of T2. Almost all these missense variants concern residues that are completely or partially buried in the T2 structure. Such variants are expected to cause T2 deficiency by having lower in vivo T2 activity because of lower folding efficiency and/or stability. Expression and activity data of 30 disease‐associated missense ACAT1 variants have been measured by expressing them in human SV40‐transformed fibroblasts. Only two variants (p.Cys126Ser and p.Tyr219His) appear to have equal stability as wild‐type. For these variants, which are inactive, the side chains point into the active site. In patients with T2 deficiency, the genotype does not correlate with the clinical phenotype but exerts a considerable effect on the biochemical phenotype. This could be related to variable remaining residual T2 activity in vivo and has important clinical implications concerning disease management and newborn screening.
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Affiliation(s)
- Elsayed Abdelkreem
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.,Department of Pediatrics, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Rajesh K Harijan
- Department of Biochemistry, Albert Einstein College of Medicine, New York, New York
| | - Seiji Yamaguchi
- Department of Pediatrics, Shimane University School of Medicine, Izumo, Japan
| | | | - Toshiyuki Fukao
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
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18
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Assessment of coding region variants in Kuwaiti population: implications for medical genetics and population genomics. Sci Rep 2018; 8:16583. [PMID: 30409984 PMCID: PMC6224454 DOI: 10.1038/s41598-018-34815-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 10/16/2018] [Indexed: 02/07/2023] Open
Abstract
Consanguineous populations of the Arabian Peninsula have been underrepresented in global efforts that catalogue human exome variability. We sequenced 291 whole exomes of unrelated, healthy native Arab individuals from Kuwait to a median coverage of 45X and characterised 170,508 single-nucleotide variants (SNVs), of which 21.7% were ‘personal’. Up to 12% of the SNVs were novel and 36% were population-specific. Half of the SNVs were rare and 54% were missense variants. The study complemented the Greater Middle East Variome by way of reporting many additional Arabian exome variants. The study corroborated Kuwaiti population genetic substructures previously derived using genome-wide genotype data and illustrated the genetic relatedness among Kuwaiti population subgroups, Middle Eastern, European and Ashkenazi Jewish populations. The study mapped 112 rare and frequent functional variants relating to pharmacogenomics and disorders (recessive and common) to the phenotypic characteristics of Arab population. Comparative allele frequency data and carrier distributions of known Arab mutations for 23 disorders seen among Arabs, of putative OMIM-listed causal mutations for 12 disorders observed among Arabs but not yet characterized for genetic basis in Arabs, and of 17 additional putative mutations for disorders characterized for genetic basis in Arab populations are presented for testing in future Arab studies.
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19
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Schwoerer JS, Drilias N, Kuhl A, Mochal S, Baker M. Genotypes of patients with phenylalanine hydroxylase deficiency in the Wisconsin Amish. Mol Genet Metab Rep 2018; 15:75-77. [PMID: 29560316 PMCID: PMC5857495 DOI: 10.1016/j.ymgmr.2018.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 02/15/2018] [Accepted: 02/17/2018] [Indexed: 11/29/2022] Open
Abstract
In the Plain Community, there is an increased frequency of genetic disorders including phenylalanine hydroxylase (PAH) deficiency. Common pathogenic variants have been observed due to founder effect and closed community. This study obtained genotypes of 12 Plain individuals with PAH deficiency, identified through newborn screen or diagnosed by symptomatic presentation, who are receiving medical care at the University of Wisconsin metabolic clinic. Genotype and phenotypic data were evaluated to characterize genotype-phenotype correlations. Results can inform the need for confirmatory testing for the disorder and provide a better understanding of the biochemical phenotype, which may help with management.
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Affiliation(s)
| | - Nicoletta Drilias
- University of Wisconsin Department of Pediatrics, Waisman Center Madison, WI, USA
| | - Ashley Kuhl
- University of Wisconsin Department of Pediatrics, Waisman Center Madison, WI, USA
| | - Sean Mochal
- Newborn Screening Laboratory, Wisconsin State Laboratory of Hygiene Madison, WI, USA
| | - Mei Baker
- University of Wisconsin Department of Pediatrics, Waisman Center Madison, WI, USA
- Newborn Screening Laboratory, Wisconsin State Laboratory of Hygiene Madison, WI, USA
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20
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Zaki OK, Priya Doss C G, Ali SA, Murad GG, Elashi SA, Ebnou MSA, Kumar D T, Khalifa O, Gamal R, El Abd HSA, Nasr BN, Zayed H. Genotype-phenotype correlation in patients with isovaleric acidaemia: comparative structural modelling and computational analysis of novel variants. Hum Mol Genet 2018; 26:3105-3115. [PMID: 28535199 DOI: 10.1093/hmg/ddx195] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 05/16/2017] [Indexed: 01/06/2023] Open
Abstract
Isovaleric acidaemia (IVA) is an autosomal recessive inborn error of leucine metabolism. It is caused by a deficiency in the mitochondrial isovaleryl-CoA dehydrogenase (IVD) enzyme. In this study, we investigated eight patients with IVA. The patients' diagnoses were confirmed by urinary organic acid analysis and the blood C5-Carnitine value. A molecular genetic analysis of the IVD gene revealed nine different variants: five were missense variants (c.1193G > A; p. R398Q, c.1207T > A; p. Y403N, c.872C > T; p. A291V, c.749G > C; p. G250A, c.1136T > C; p.I379T), one was a frameshift variant (c.ins386 T; p. Y129fs), one was a splicing variant (c.465 + 2T > C), one was a polymorphism (c.732C > T; p. D244D), and one was an intronic benign variant (c.287 + 14T > C). Interestingly, all variants were in homozygous form, and four variants were novel (p. Y403N, p. Y129fs, p. A291V, p. G250A) and absent from 200 normal chromosomes. We performed protein modelling and dynamics analyses, pathogenicity and stability analyses, and a physiochemical properties analysis of the five missense variants (p.Y403N, R398Q, p.A291V, p.G250A, and p.I379T). Variants p.I379T and p.R398Q were found to be the most deleterious and destabilizing compared to variants p.A291V and p.Y403N. However, the four variants were predicted to be severe by the protein dynamic and in silico analysis, which was consistent with the patients' clinical phenotypes. The p.G250A variant was computationally predicted as mild, which was consistent with the severity of the clinical phenotype. This study reveals a potentially meaningful genotype-phenotype correlation for our patient cohort and highlights the development and use of this computational analysis for future assessments of genetic variants in the clinic.
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Affiliation(s)
- Osama K Zaki
- Department of Medical Genetics, Ain Shams Paediatrics Hospital, Cairo, Egypt
| | - George Priya Doss C
- Department of Integrative Biology, School of Biosciences and Technology, VIT University, Vellore 632014, Tamil Nadu, India
| | - Salsabil A Ali
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha, Qatar
| | - Ghadeer G Murad
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha, Qatar
| | - Shaima A Elashi
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha, Qatar
| | - Maryam S A Ebnou
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha, Qatar
| | - Thirumal Kumar D
- Department of Integrative Biology, School of Biosciences and Technology, VIT University, Vellore 632014, Tamil Nadu, India
| | - Ola Khalifa
- Department of Medical Genetics, Ain Shams Paediatrics Hospital, Cairo, Egypt
| | - Radwa Gamal
- Department of Medical Genetics, Ain Shams Paediatrics Hospital, Cairo, Egypt
| | - Heba S A El Abd
- Department of Medical Genetics, Ain Shams Paediatrics Hospital, Cairo, Egypt
| | - Bilal N Nasr
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha, Qatar
| | - Hatem Zayed
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha, Qatar
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A Novel Mutation of Beta-ketothiolase Deficiency: The First Report from Iran and Review of Literature. IRANIAN JOURNAL OF CHILD NEUROLOGY 2018; 12:113-121. [PMID: 30026775 PMCID: PMC6045933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 05/30/2017] [Accepted: 08/26/2017] [Indexed: 11/15/2022]
Abstract
Beta-ketothiolase deficiency is a rare autosomal recessive disorder characterized by an inborn error of isoleucine catabolism and affecting ketone body metabolism. Clinical features characterized by intermittent keto acidotic episodes are associated with clinical signs and symptoms of toxic encephalopathy such as lethargy, hypotonia, vomiting, tachypnea, and coma in some patients, with an onset during infancy or toddler-hood. A two months old girl presented to pediatric ward of Imam Reza Hospital in Mashhad City, Northwestern Iran in October 2016, with acute episode of fever and toxic encephalopathy with attack of vomiting, hypotonia, lethargy, tonic-clonic seizures and then a day in coma, few days after vaccination. After then similar episodes happened until 7 months age. Bio chemical tests that suggested diagnose of beta ketothiolase deficiency were attacks of ketoacidosis with urinary exertion of 2-methyl-3-hydroxybutyric acid 2-methyl aceto acetic acid tiglylglycine. In genetic assessment, we detected a novel homozygous mutation c.664A> C (p. Ser 222 Arg) in ACAT gene. This is the first report of beta ketothiolase deficiency confirmed by molecular analysis from Iran. We report on a homozygous variant in the ACAT1 gene and that is a novel mutation. We recommended carrier testing for all informative family members to recognize mutations in asymptomatic family members.
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Abdelkreem E, Alobaidy H, Aoyama Y, Mahmoud S, Abd El Aal M, Fukao T. Two Libyan siblings with beta-ketothiolase deficiency: A case report and review of literature. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2017. [DOI: 10.1016/j.ejmhg.2016.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Molecular Aspects of the FAH Mutations Involved in HT1 Disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 959:25-48. [PMID: 28755182 DOI: 10.1007/978-3-319-55780-9_3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Hereditary tyrosinemia type 1 (HT1) is caused by the lack of fumarylacetoacetate hydrolase (FAH), the last enzyme of the tyrosine catabolic pathway. Up to now, around 100 mutations in the FAH gene have been associated with HT1, and despite many efforts, no clear correlation between genotype and clinical phenotype has been reported. At first, it seems that any mutation in the gene results in HT1. However, placing these mutations in their molecular context allows a better understanding of their possible effects. This chapter presents a closer look at the FAH gene and its corresponding protein in addition to provide a complete record of all the reported mutations causing HT1.
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Zhang X, Luo Q. Clinical and laboratory analysis of late-onset glutaric aciduria type I (GA-I) in Uighur: A report of two cases. Exp Ther Med 2016; 13:560-566. [PMID: 28352331 PMCID: PMC5348702 DOI: 10.3892/etm.2016.4007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 10/05/2016] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to investigate the clinical, biochemical and genetic mutation characteristics of two cases of late-onset glutaric aciduria type I (GA-I) in Uighur. The clinical data and glutaryl-CoA dehydrogenase (GCDH) genetic test results of two cases of late-onset GA-I in Uighur were collected and analyzed, and reviewed with relevant literature. One patient with late-onset GA-I primarily exhibited clinical intermittent headache, while the other patient was asymptomatic. The urinary organic acid analysis detected a large number of glutaric acid and 3-hydroxy glutaric acid, 3-hydroxy-propionic acid. One patient exhibited white matter degeneration in cranial magnetic resonance imaging (MRI) and the other patient showed no abnormality. The two patients both exhibited c. 1204C >T, p.R402W, heterozygous mutation, and c. 532G >A, p.G178R, heterozygous mutation. Besides central nervous system infectious diseases, patients with clinical headache, cranial MRI-suggested bilateral temporal lobe arachnoid cyst and abnormal signals in the basal ganglia should be highly suspected as late-onset GA-I. Early diagnosis and correct treatment are key to improve its prognosis.
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Affiliation(s)
- Xiaoying Zhang
- Department of Pediatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, P.R. China
| | - Qiong Luo
- Department of Pediatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, P.R. China
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Al-Shamsi A, Hertecant JL, Souid AK, Al-Jasmi FA. Whole exome sequencing diagnosis of inborn errors of metabolism and other disorders in United Arab Emirates. Orphanet J Rare Dis 2016; 11:94. [PMID: 27391121 PMCID: PMC4939014 DOI: 10.1186/s13023-016-0474-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 06/22/2016] [Indexed: 12/16/2022] Open
Abstract
Background This study reports on the use of whole exome sequencing (WES) to diagnose children with inborn errors of metabolism and other disorders in United Arab Emirates. Methods From January 2012 to December 2014, 85 patients (46 % females) were seen in the metabolic center at Tawam Hospital (Abu Dhabi) and WES testing was requested because definitive diagnoses were not reached by conventional methods. Results Eighty (93 %) patients were <18 years old and 44 (52 %) were <5 years. Sixty-eight (80 %) patients had neurologic abnormalities. WES facilitated rapid diagnosis in 50 % of the patients, especially those with mitochondrial disorders. Yet, in most cases extensive investigation was required after the results were available. Most patients with confirmed molecular diagnoses had autosomal recessive disorders and were homozygous for the rare alleles. Most patients with autosomal dominant disorders and all patients with X-linked disorders had de novo mutations. WES results were negative (no pathogenic variants related to patient phenotype were identified) in six patients and incorrect in two patients. One patient had a reported “deleterious” hemizygous mutation in SLC35A2, c.617_620del (p.Q206fs), suggesting ‘congenital disorder of glycosylation, TYPE IIm’, but glycosylation studies were normal and healthy brothers had the same mutation. Another patient had “pathogenic” mutation in MCCC2, c.1015G > A (p.V339M), but urine organic acids was normal. WES confirmed inborn errors of metabolism (five mitochondrial diseases, three lysosomal storage diseases, and six other disorders) in 14 patients and genetic disorders (14 neurological diseases and three non-neurological diseases) in 17 patients. Variants of unknown significance were identified in 48 patients; 12 had “confirmed pathologic variants”and 12 had “likely pathologic variants”, based on consistent phenotypes, biochemical/ segregation studies, or reported pathogenicity. In 24 patients, the variants were inconsistent with phenotypes or biochemical/ familial studies. Conclusions Although WES provided molecular diagnoses, the results required careful interpretations and many patients required additional investigations. This tool is useful when conventional diagnostic methods fail. Staff competence in obtaining consent/ permission, interpreting the findings, and providing the proper counseling are essential before incorporating this technology into routine clinical practices.
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Affiliation(s)
| | | | - Abdul-Kader Souid
- Department of Pediatrics, United Arab Emirates University, P.O. Box 17666, Al-Ain, UAE
| | - Fatma A Al-Jasmi
- Department of Pediatrics, United Arab Emirates University, P.O. Box 17666, Al-Ain, UAE.
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Alfadhel M, Mutairi FA, Makhseed N, Jasmi FA, Al-Thihli K, Al-Jishi E, AlSayed M, Al-Hassnan ZN, Al-Murshedi F, Häberle J, Ben-Omran T. Guidelines for acute management of hyperammonemia in the Middle East region. Ther Clin Risk Manag 2016; 12:479-87. [PMID: 27099506 PMCID: PMC4820220 DOI: 10.2147/tcrm.s93144] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Hyperammonemia is a life-threatening event that can occur at any age. If treated, the early symptoms in all age groups could be reversible. If untreated, hyperammonemia could be toxic and cause irreversible brain damage to the developing brain. Objective There are major challenges that worsen the outcome of hyperammonemic individuals in the Middle East. These include: lack of awareness among emergency department physicians about proper management of hyperammonemia, strained communication between physicians at primary, secondary, and tertiary hospitals, and shortage of the medications used in the acute management of hyperammonemia. Therefore, the urge to develop regional guidelines is extremely obvious. Method We searched PubMed and Embase databases to include published materials from 2011 to 2014 that were not covered by the European guidelines, which was published in 2012. We followed the process of a Delphi conference and involved one preliminary meeting and two follow-up meetings with email exchanges between the Middle East Hyperammonemia and Urea Cycle Disorders Scientific Group regarding each draft of the manuscript. Results and discussion We have developed consensus guidelines based on the highest available level of evidence. The aim of these guidelines is to homogenize and harmonize the treatment protocols used for patients with acute hyperammonemia, and to provide a resource to not only metabolic physicians, but also physicians who may come in contact with individuals with acute hyperammonemia. Conclusion These suggested guidelines aim to ease the challenges faced by physicians dealing with acute hyperammonemia in the region. In addition, guidelines have demonstrated useful collaboration between experts in the region, and provides information that will hopefully improve the outcomes of patients with acute hyperammonemia.
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Affiliation(s)
- Majid Alfadhel
- Department of Pediatrics, Division of Genetics, King Abdulaziz Medical City, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Fuad Al Mutairi
- Department of Pediatrics, Division of Genetics, King Abdulaziz Medical City, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Nawal Makhseed
- Department of Pediatrics, Jahra Hospital, Ministry of Health, Jahra City, Kuwait
| | - Fatma Al Jasmi
- Department of Pediatric, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Khalid Al-Thihli
- Genetic and Developmental Medicine Clinic, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman
| | | | - Moeenaldeen AlSayed
- Department of Medical Genetics, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Zuhair N Al-Hassnan
- Department of Medical Genetics, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; The National Newborn Screening Program, Ministry of Health, Riyadh, Saudi Arabia
| | - Fathiya Al-Murshedi
- Genetic and Developmental Medicine Clinic, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman
| | - Johannes Häberle
- Department of Pediatrics, Division of Metabolism and Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Tawfeg Ben-Omran
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar
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Mekaini LAA, Denic S, Jabri ONA, Narchi H, Souid AK, Al-Hammadi S. Red cell parameters in infant and children from the Arabian Peninsula. AMERICAN JOURNAL OF BLOOD RESEARCH 2015; 5:101-107. [PMID: 27069759 PMCID: PMC4769353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 12/23/2015] [Indexed: 06/05/2023]
Abstract
α+-Thalassemia trait and iron deficiency anemia are frequent causes of microcytosis and a common diagnostic challenge in Arabian children. In this study, their prevalences and effects on the red cell parameters were evaluated in 28,457 children aged one day to 6 years. α+-Thalassemia trait was considered to be present when mean cell volume (MCV) was <94 fL at birth and iron deficiency anemia when red cell distribution width (RDW) was >14.5%. The prevalence of α+-thalassemia trait was 15.7% (502/3,191), which was similar to previously reported values for adults (9-14%). Iron deficiency anemia peaked at 7 months (53%) and then declined at a rate of 8% per year. The nadirs of red blood cell count (RBC) and hemoglobin concentration (Hb) occurred at two months of age (physiological anemia). Subsequently, Hb increased at a rate similar to that of MCV, demonstrating the two processes are coupled. The third percentile MCV in children older than 3 months was ≤64 fL, which was significantly lower than that in European children. The third percentile Hb, on the other hand, was similar to that in European children. Thus, α+-thalassemia trait and iron deficiency anemia are exceptionally frequent in Arabian children and their red cell indices are considerably different from European-based norms. Careful interpretation of red cell parameters is required for the evaluation of microcytic anemia in Arabian children.
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Affiliation(s)
| | - Srdjan Denic
- Department of Medicine, United Arab Emirates UniversityAl-Ain, UAE
| | | | - Hassib Narchi
- Department of Pediatrics, United Arab Emirates UniversityAl-Ain, UAE
| | - Abdul-Kader Souid
- Department of Pediatrics, United Arab Emirates UniversityAl-Ain, UAE
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Inborn Errors of Metabolism in the United Arab Emirates: Disorders Detected by Newborn Screening (2011-2014). JIMD Rep 2015; 28:127-135. [PMID: 26589311 DOI: 10.1007/8904_2015_512] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 09/30/2015] [Accepted: 10/05/2015] [Indexed: 01/30/2023] Open
Abstract
This study reports on the inborn errors of metabolism (IEM) detected by our national newborn screening between 2011 and 2014. One hundred fourteen patients (55 UAE citizens and 59 residents) were diagnosed during this period. The program was most comprehensive (tested 29 IEM) and universally applied in 2013, giving an incidence of 1 in 1,787 citizens. This relatively high prevalence resulted from the frequent consanguineous marriages (81.5%) among affected families. The following eight disorders accounted for 80% of the entities: biotinidase deficiency (14 of 55), phenylketonuria (11 of 55), 3-methylcrotonyl glycinuria (9 of 55), medium-chain acyl-CoA dehydrogenase deficiency (4 of 55), argininosuccinic aciduria, glutaric aciduria type 1, glutaric aciduria type 2, and methylmalonyl-CoA mutase deficiency (2 of 55 each). Mutation analysis was performed in 48 (87%) of the 55 patients, and 33 distinct mutations were identified. Twenty-nine (88%) mutations were clinically significant and, thus, could be included in our premarital screening. Most mutations were homozygous, except for the biotinidase deficiency. The BTD mutations c.1207T>G (found in citizens) and c.424C>A (found in Somalians) were associated with undetectable biotinidase activity. Thus, the high prevalence of IEM in our region is amenable to newborn and premarital screening, which is expected to halt most of these diseases.
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Karaca M, Özgül RK, Ünal Ö, Yücel-Yılmaz D, Kılıç M, Hişmi B, Tokatlı A, Coşkun T, Dursun A, Sivri HS. Detection of biotinidase gene mutations in Turkish patients ascertained by newborn and family screening. Eur J Pediatr 2015; 174:1077-84. [PMID: 25754625 DOI: 10.1007/s00431-015-2509-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 02/16/2015] [Accepted: 02/19/2015] [Indexed: 11/29/2022]
Abstract
UNLABELLED The incidence of biotinidase deficiency in Turkey is currently one of the highest in the world. To expand upon the information about the biotinidase gene (BTD) variations in Turkish patients, we conducted a mutation screening in a large series (n = 210) of probands with biotinidase deficiency, using denaturing high-performance liquid chromatography and direct DNA sequencing. The putative effects of novel mutations were predicted by computational program. Twenty-six mutations, including six novels (p.C143F, p.T244I, c.1212-1222del11, c.1320delG, p.V457L, p.G480R) were identified. Nine of the patients were symptomatic at the initial clinical assessment with presentations of seizures, encephalopathy, and lactic acidemia. The most common mutation in this group of symptomatic patients was c.98-104 del7ins3. Among the screened patients, 72 have partial and 134 have profound biotinidase deficiency (BD) of which 106 are homozygous for BTD mutations. The common mutations (p.R157H, p.D444H, c.98-104del7ins3, p.T532M) cumulatively accounted for 72.3% of all the mutant alleles in the Turkish population. CONCLUSION The identification of common mutations and hot spot regions of the BTD gene in Turkish patients is important for mutation screening in the Turkish population and helps to ascertain carriers, may have impact on genetic counseling and implementing prevention programs.
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Affiliation(s)
- Mehmet Karaca
- Faculty of Science and Arts, Department of Biology, Aksaray University, Aksaray, Turkey,
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Zayed H. Propionic acidemia in the Arab World. Gene 2015; 564:119-24. [PMID: 25865301 DOI: 10.1016/j.gene.2015.04.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 03/29/2015] [Accepted: 04/07/2015] [Indexed: 12/16/2022]
Abstract
The autosomal recessive disease propionic acidemia (PA) is an inborn error of metabolism with highly variable clinical manifestations, caused by a deficiency of propionyl-CoA carboxylase (PCC) enzyme, due to mutations in either PCCA or PCCB genes, which encode the alpha and beta subunits of the PCC enzyme, respectively. The classical clinical presentation consists of poor feeding, vomiting, metabolic acidosis, hyperammonemia, lethargy, neurological problems, and developmental delay. PA seems to be a prevalent disease in the Arab World. Arab patients with PA seem to have the same classical clinical picture for PA with distinctive associated complications and other diseases. Most of the mutations found in Arab patients seem to be specific to the Arab population, and not observed in other ethnic groups. In this review, I will discuss in details the clinical and molecular profile of Arab patients with PA.
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Affiliation(s)
- Hatem Zayed
- Department of Health Sciences, Biomedical Program, Qatar University, Doha, Qatar.
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Geographical and Ethnic Distribution of Mutations of the Fumarylacetoacetate Hydrolase Gene in Hereditary Tyrosinemia Type 1. JIMD Rep 2015; 19:43-58. [PMID: 25681080 DOI: 10.1007/8904_2014_363] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 09/04/2014] [Accepted: 09/09/2014] [Indexed: 12/04/2022] Open
Abstract
Hereditary tyrosinemia type 1 (HT1) (OMIM 276700) is a severe inherited metabolic disease affecting mainly hepatic and renal functions that leads to a fatal outcome if untreated. HT1 results from a deficiency of the last enzyme of tyrosine catabolism, fumarylacetoacetate hydrolase (FAH). Biochemical findings include elevated succinylacetone in blood and urine; elevated plasma concentrations of tyrosine, methionine and phenylalanine; and elevated tyrosine metabolites in urine. The HT1 frequency worldwide is about 1 in 100,000 individuals. In some areas, where the incidence of HT1 is noticeably higher, prevalence of characteristic mutations has been reported, and the estimated incidence of carriers of a specific mutation can be as high as 1 out of 14 adults. Because the global occurrence of HT1 is relatively low, a considerable number of cases may go unrecognized, underlining the importance to establish efficient prenatal and carrier testing to facilitate an early detection of the disease. Here we describe the 95 mutations reported so far in HT1 with special emphasis on their geographical and ethnic distributions. Such information should enable the establishment of a preferential screening process for mutations most predominant in a given region or ethnic group.
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