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Pajares S, Arranz JA, Ormazabal A, Toro MD, García-Cazorla Á, Navarro-Sastre A, López RM, Meavilla SM, de Los Santos MM, García-Volpe C, de Aledo-Castillo JMG, Argudo A, Marín JL, Carnicer C, Artuch R, Tort F, Gort L, Fernández R, García-Villoria J, Ribes A. Correction to: implementation of second-tier tests in newborn screening for the detection of vitamin B12 related acquired and genetic disorders: results on 258,637 newborns. Orphanet J Rare Dis 2023; 18:188. [PMID: 37443087 DOI: 10.1186/s13023-023-02793-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023] Open
Affiliation(s)
- Sonia Pajares
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, Barcelona, 08028, Spain
- Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain
| | | | - Aida Ormazabal
- Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain
- Inborn Errors of Metabolism Unit, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Mireia Del Toro
- Unit of Metabolic Diseases, Hospital Vall D'Hebrón, Barcelona, Spain
| | - Ángeles García-Cazorla
- Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain
- Inborn Errors of Metabolism Unit, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Aleix Navarro-Sastre
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, Barcelona, 08028, Spain
| | - Rosa María López
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, Barcelona, 08028, Spain
- Biomedical Research Institute, August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | | | | | - Camila García-Volpe
- Inborn Errors of Metabolism Unit, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jose Manuel González de Aledo-Castillo
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, Barcelona, 08028, Spain
| | - Ana Argudo
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, Barcelona, 08028, Spain
| | - Jose Luís Marín
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, Barcelona, 08028, Spain
| | - Clara Carnicer
- Unit of Metabolic Diseases, Hospital Vall D'Hebrón, Barcelona, Spain
| | - Rafael Artuch
- Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain
- Inborn Errors of Metabolism Unit, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Frederic Tort
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, Barcelona, 08028, Spain
- Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain
- Biomedical Research Institute, August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Laura Gort
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, Barcelona, 08028, Spain
- Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain
- Biomedical Research Institute, August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Rosa Fernández
- Maternal and Child Health Service, Public Health Agency of Catalonia, Health Department, Government of Catalonia, Barcelona, Spain
| | - Judit García-Villoria
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, Barcelona, 08028, Spain
- Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain
- Biomedical Research Institute, August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Antonia Ribes
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, Barcelona, 08028, Spain.
- Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain.
- Biomedical Research Institute, August Pi I Sunyer (IDIBAPS), Barcelona, Spain.
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Tangeraas T, Constante JR, Backe PH, Oyarzábal A, Neugebauer J, Weinhold N, Boemer F, Debray FG, Ozturk-Hism B, Evren G, Tuba EF, Ummuhan O, Footitt E, Davison J, Martinez C, Bueno C, Machado I, Rodríguez-Pombo P, Al-Sannaa N, De Los Santos M, Muchart López J, Ozturkmen-Akay H, Karaca M, Tekin M, Pajares S, Ormazabal A, Stoway SD, Artuch R, Dixon M, Mørkrid L, García-Cazorla A. BCKDK deficiency: a treatable neurodevelopmental disease amenable to newborn screening. Brain 2023:7024722. [PMID: 36729635 DOI: 10.1093/brain/awad010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/13/2022] [Accepted: 11/27/2022] [Indexed: 02/03/2023] Open
Abstract
There are few causes of treatable neurodevelopmental diseases described to date. Branched Chain Ketoacid Dehydrogenase Kinase (BCKDK) deficiency causes branched-chain amino acid (BCAA) depletion and is linked to a neurodevelopmental disorder characterized by autism, intellectual disability, and microcephaly. We report the largest cohort of patients studied, broadening the phenotypic and genotypic spectrum. Moreover, this is the first study to present newborn screening findings and mid-term clinical outcome. In this cross-sectional study, patients with a diagnosis of BCKDK deficiency were recruited via investigators' practices through a MetabERN initiative. Clinical, biochemical and genetic data were collected. Dried blood spot (DBS) newborn screening (NBS) amino acid profiles were retrieved from collaborating centers and compared to a healthy newborn reference population. Twenty-one patients with BCKDK mutations were included from 13 families. Patients were diagnosed between 8 months and 16 years (mean: 5.8 years, 43% female). At diagnosis, BCAA levels (leucine, valine, and isoleucine) were below reference values in plasma and in cerebrospinal fluid. All patients had global neurodevelopmental delay; 18/21 had gross motor function (GMF) impairment with GMF III or worse in 5/18, 16/16 intellectual disability, 17/17 language impairment, 12/17 autism spectrum disorder, 9/21 epilepsy, 12/15 clumsiness, 3/21 had sensorineural hearing loss and 4/20 feeding difficulties. No microcephaly was observed at birth, but 17/20 developed microcephaly during follow-up. Regression was reported in 6 patients. Movement disorder was observed in 3/21 patients: hyperkinetic movements (1), truncal ataxia (1) and dystonia (2). After treatment with high protein diet (≥ 2 g/kg/day) and BCAA supplementation (100-250 mg/kg/day), plasma BCAA increased significantly (p < 0.001), motor functions and head circumference stabilized/improved in 13/13 and in 11/15 patients, respectively. Amongst cases with follow-up data, none of the 3 patients starting treatment before 2 years of age developed autism at follow-up. The patient with the earliest age of treatment initiation (8 months) showed normal development at 3 years of age. NBS in DBS identified BCAA levels significantly lower than those of the normal population. This work highlights the potential benefits of dietetic treatment, in particular early introduction of BCAA. Therefore, it is of utmost importance to increase awareness about this treatable disease and consider it as a candidate for early detection by NBS programs.
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Affiliation(s)
- Trine Tangeraas
- Paediatric and Adolescent Medicine, Oslo University Hospital, 0424, Oslo, Norway.,European Reference Network for Hereditary Metabolic Diseases (MetabERN)
| | - Juliana R Constante
- European Reference Network for Hereditary Metabolic Diseases (MetabERN).,Neurometabolic Unit and Synaptic Metabolism Laboratory, Neurology Department Sant Joan de Déu Hospital, IPR, Barcelona 08950, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Paul Hoff Backe
- European Reference Network for Hereditary Metabolic Diseases (MetabERN).,Department of Medical Biochemistry, Oslo University Hospital-Rikshospitalet, PO Box 4950 Nydalen, OUS HF Rikshospitalet, 0424 Oslo Norway.,Department of Microbiology, Clinic for Diagnostics and Intervention, Oslo University Hospital, Rikshospitalet, PO Box 4950, Nydalen, N-0424, Oslo, Norway
| | - Alfonso Oyarzábal
- European Reference Network for Hereditary Metabolic Diseases (MetabERN).,Neurometabolic Unit and Synaptic Metabolism Laboratory, Neurology Department Sant Joan de Déu Hospital, IPR, Barcelona 08950, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Julia Neugebauer
- European Reference Network for Hereditary Metabolic Diseases (MetabERN).,Department of Pediatric Gastroenterology, Nephrology and Metabolic Medicine. Charité - Universitätsmedizin Berlin, Berlin 13353, Germany.,Center for Chronically Sick Children, Charité - Universitätsmedizin Berlin, Berlin 13353, Germany
| | - Natalie Weinhold
- European Reference Network for Hereditary Metabolic Diseases (MetabERN).,Department of Pediatric Gastroenterology, Nephrology and Metabolic Medicine. Charité - Universitätsmedizin Berlin, Berlin 13353, Germany.,Center for Chronically Sick Children, Charité - Universitätsmedizin Berlin, Berlin 13353, Germany
| | - Francois Boemer
- European Reference Network for Hereditary Metabolic Diseases (MetabERN).,Biochemical Genetics Laboratory, Human Genetics, CHU of Liege, University of Liège, Liège, 4000, Belgium
| | - François G Debray
- European Reference Network for Hereditary Metabolic Diseases (MetabERN).,Department of Human Genetics, CHU of Liege, University of Liège, Liège, 4000, Belgium
| | - Burcu Ozturk-Hism
- Department of Pediatric Metabolic Diseases, Marmara University School of Medicine, Istanbul 34854, Turkey
| | - Gumus Evren
- Medical Genetics Department, University of Harran 63000 Sanliurfa, Turkey
| | - Eminoglu F Tuba
- Pediatric Metabolism Department, Ankara University School of Medicine, 06100 Ankara, Turkey
| | - Oncul Ummuhan
- Pediatric Metabolism Department, Ankara University School of Medicine, 06100 Ankara, Turkey
| | - Emma Footitt
- European Reference Network for Hereditary Metabolic Diseases (MetabERN).,Metabolic Medicine Department, Great Ormond Street Hospital for Children, London WC1N 3JH, UK.,NIHR Great Ormond Street Hospital Biomedical Research Centre (NIHR GOSH BRC), London WC1N 3JH, UK
| | - James Davison
- European Reference Network for Hereditary Metabolic Diseases (MetabERN).,Metabolic Medicine Department, Great Ormond Street Hospital for Children, London WC1N 3JH, UK.,NIHR Great Ormond Street Hospital Biomedical Research Centre (NIHR GOSH BRC), London WC1N 3JH, UK
| | - Caroline Martinez
- Department of Pediatrics and Psychiatry, The Mount Sinai Hospital, New York 1468, USA
| | - Clarissa Bueno
- Neurology Department, Clinical Hospital of the Faculty of Medicine, University of São Paulo, São Paulo 05403-010, Brazil
| | - Irene Machado
- Hospital Universitario Clínico San Cecilio, Granada, 18016, Spain
| | - Pilar Rodríguez-Pombo
- Centro de Diagnóstico de Enfermedades Moleculares, Centro de Biología Molecular Severo Ochoa, CBM-CSIC, Departamento de Biología Molecular, Institute for Molecular Biology-IUBM, Universidad Autónoma Madrid, CIBERER, IDIPAZ, 28049 Madrid, Spain
| | - Nouriya Al-Sannaa
- Pediatric Services Division, Johns Hopkins Aramco Healthcare, Dhahran 34465, Saudi Arabia
| | - Mariela De Los Santos
- European Reference Network for Hereditary Metabolic Diseases (MetabERN).,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid 28029, Spain.,Neurometabolic Unit, Gastroenterology and Nutrition Department, Sant Joan de Déu Hospital, Barcelona 08950, Spain
| | - Jordi Muchart López
- Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Pediatric Radiology Department Esplugues de Llobregat, 08950 Barcelona, Spain
| | | | - Meryem Karaca
- Pediatric Metabolic Diseases Department, University of Harran, Sanliurfa 63000, Turkey
| | - Mustafa Tekin
- Dr. John T. Macdonald Foundation Department of Human Genetics and John P.Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami 33136, USA
| | - Sonia Pajares
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid 28029, Spain.,Section of Inborn Errors of Metabolism-IBC, Department of Biochemistry and Molecular Genetics, Hospital Clínic, Barcelona 08036, Spain
| | - Aida Ormazabal
- European Reference Network for Hereditary Metabolic Diseases (MetabERN).,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid 28029, Spain.,Clinical Biochemistry Department, Sant Joan de Déu Hospital, Barcelona 08950, Spain
| | - Stephanie D Stoway
- Norwegian National Unit for Newborn Screening, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo 0424, Norway.,Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester 55905, USA
| | - Rafael Artuch
- European Reference Network for Hereditary Metabolic Diseases (MetabERN).,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid 28029, Spain.,Clinical Biochemistry Department, Sant Joan de Déu Hospital, Barcelona 08950, Spain
| | - Marjorie Dixon
- European Reference Network for Hereditary Metabolic Diseases (MetabERN).,Dietetics, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, WC1N, 3JH, UK
| | - Lars Mørkrid
- European Reference Network for Hereditary Metabolic Diseases (MetabERN).,Department of Medical Biochemistry, Oslo University Hospital-Rikshospitalet, PO Box 4950 Nydalen, OUS HF Rikshospitalet, 0424 Oslo Norway.,Institute of Clinical Medicine, University of Oslo, PO Box 4950, Nydalen, N-0424, Norway
| | - Angeles García-Cazorla
- European Reference Network for Hereditary Metabolic Diseases (MetabERN).,Neurometabolic Unit and Synaptic Metabolism Laboratory, Neurology Department Sant Joan de Déu Hospital, IPR, Barcelona 08950, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid 28029, Spain
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Guiñón L, Soler A, López RM, Pajares S, de Aledo JMG, Argudo-Ramírez A, Marín JL, García-Villoria J, Sahuquillo Á, Alvarez L. Inter-rater reliability assessment for the new-born screening quality assurance. Biochem Med (Zagreb) 2022; 32:030901. [PMID: 35966259 PMCID: PMC9344869 DOI: 10.11613/bm.2022.030901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/20/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction To ensure the quality of the new-born screening (NBS), our laboratory reviewed the analytical procedure to detect subjective steps that may represent a risk to the patient. Two subjective activities were identified in the extra-analytical phases: the classification of dried blood spots (DBS) according to their quality and the assignment of haemoglobin patterns. To keep these activities under control, inter-rater studies were implemented. This study aimed to evaluate the inter-rater reliability and the effectiveness of the measures taken to improve the agreement between observers, to assure NBS results’ quality. Materials and methods Dried blood spots specimens were used for the inter-rater studies. Ten studies were performed to assess DBS quality classification, and four to assess the assignment of haemoglobin patterns. Krippendorff’s alpha test was used to estimate inter-rater reliability. Causes were investigated when alpha values were below 0.80. Results For both activities, the reliability obtained in the first studies was inadequate. After investigation, we detected that the criterion to classify a DBS as scant was not consolidated, and also a lack of consensus on whether or not to report Bart’s haemoglobin depending on its percentage. Alpha estimates became higher once the training was reinforced and a consensus about the appropriate criteria to be applied was reached. Conclusion Inter-rater reliability assessment helped us to ensure the quality of subjective activities that could add variability to NBS results. Furthermore, the evolution of the alpha value over time allowed us to verify the effectiveness of the measures adopted.
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Affiliation(s)
- Leonor Guiñón
- Quality Department, Biomedical Diagnostic Center, Hospital Clínic of Barcelona, Barcelona, Spain
- Quality Department, Laboratories, Hospital de la Santa Creu i Sant Pau of Barcelona, Barcelona, Spain
- Biochemistry Department, Hospital de la Santa Creu i Sant Pau of Barcelona, Barcelona, Spain
- Corresponding author:
| | - Anna Soler
- Quality Department, Biomedical Diagnostic Center, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Rosa María López
- Division of Inborn Errors of Metabolism, Biochemistry and Molecular Genetics Department, Biomedical Diagnostic Center, Hospital Clínic of Barcelona, IDIBAPS, BarcelonaSpain
| | - Sonia Pajares
- Division of Inborn Errors of Metabolism, Biochemistry and Molecular Genetics Department, Biomedical Diagnostic Center, Hospital Clínic of Barcelona, IDIBAPS, BarcelonaSpain
- Spain Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain
| | - José Manuel González de Aledo
- Division of Inborn Errors of Metabolism, Biochemistry and Molecular Genetics Department, Biomedical Diagnostic Center, Hospital Clínic of Barcelona, IDIBAPS, BarcelonaSpain
| | - Ana Argudo-Ramírez
- Division of Inborn Errors of Metabolism, Biochemistry and Molecular Genetics Department, Biomedical Diagnostic Center, Hospital Clínic of Barcelona, IDIBAPS, BarcelonaSpain
| | - José Luis Marín
- Division of Inborn Errors of Metabolism, Biochemistry and Molecular Genetics Department, Biomedical Diagnostic Center, Hospital Clínic of Barcelona, IDIBAPS, BarcelonaSpain
| | - Judit García-Villoria
- Division of Inborn Errors of Metabolism, Biochemistry and Molecular Genetics Department, Biomedical Diagnostic Center, Hospital Clínic of Barcelona, IDIBAPS, BarcelonaSpain
- Spain Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Ángeles Sahuquillo
- Section of Analytical Chemistry, Faculty of Chemistry, University of Barcelona, Barcelona, Spain
| | - Luisa Alvarez
- Quality Department, Biomedical Diagnostic Center, Hospital Clínic of Barcelona, Barcelona, Spain
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Pajares S, Gómez-Álvarez J, Sola-Mallo X. Scaphometacarpal Stabilization Technique for Repairable Scapholunate Injury. Revista Iberoamericana de Cirugía de la Mano 2022. [DOI: 10.1055/s-0042-1743279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
AbstractDespite the numerous techniques (both arthroscopic and open) for the treatment of acute scapholunate instability, there is no consensus on which one results in better healing of the ligaments. In the present work, we describe a new surgical technique to achieve stability of the scaphoid that enables the reduction inflexion and pronation of this bone when dissociation is produced. Using a high-strength suture wire with double cortical button anchor (Mini TightRope, Arthrex, Naples, FL, US, or MicroLink, Conmed, Largo, FL, US) stabilization of the scaphoid is achieved to protect ligament healing without the need for postoperative immobilization.
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Affiliation(s)
- S. Pajares
- Orthopedic Surgery and Traumatology Department, Clínica Universidad de Navarra, Madrid, Madrid, Spain
| | - J. Gómez-Álvarez
- Orthopedic Surgery and Traumatology Department, Clínica Universidad de Navarra, Madrid, Madrid, Spain
| | - X Sola-Mallo
- Department of Orthopedic Surgery, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Galicia, Spain
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Pajares S, Arranz JA, Ormazabal A, Del Toro M, García-Cazorla Á, Navarro-Sastre A, López RM, Meavilla SM, de Los Santos MM, García-Volpe C, de Aledo-Castillo JMG, Argudo A, Marín JL, Carnicer C, Artuch R, Tort F, Gort L, Fernández R, García-Villoria J, Ribes A. Implementation of second-tier tests in newborn screening for the detection of vitamin B 12 related acquired and genetic disorders: results on 258,637 newborns. Orphanet J Rare Dis 2021; 16:195. [PMID: 33931066 PMCID: PMC8086297 DOI: 10.1186/s13023-021-01784-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/16/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Alteration of vitamin B12 metabolism can be genetic or acquired, and can result in anemia, failure to thrive, developmental regression and even irreversible neurologic damage. Therefore, early diagnosis and intervention is critical. Most of the neonatal cases with acquired vitamin B12 deficiency have been detected by clinical symptoms and only few of them trough NBS programs. We aim to assess the usefulness of the second-tier test: methylmalonic acid (MMA), methylcitric acid (MCA) and homocysteine (Hcys) in our newborn screening program and explore the implications on the detection of cobalamin (vitamin B12) related disorders, both genetic and acquired conditions. METHODS A screening strategy using the usual primary markers followed by the analysis of MMA, MCA and Hcys as second tier-test in the first dried blood spot (DBS) was developed and evaluated. RESULTS During the period 2015-2018 a total of 258,637 newborns were screened resulting in 130 newborns with acquired vitamin B12 deficiency (incidence 1:1989), 19 with genetic disorders (incidence 1:13,613) and 13 were false positive. No false negatives were notified. Concerning the second-tier test, the percentage of cases with MMA above the cut-off levels, both for genetic and acquired conditions was very similar (58% and 60%, respectively). Interestingly, the percentage of cases with increased levels of Hcys was higher in acquired conditions than in genetic disorders (87% and 47%, respectively). In contrast, MCA was high only in 5% of the acquired conditions versus in 53% of the genetic disorders, and it was always very high in all patients with propionic acidemia. CONCLUSIONS When screening for methylmalonic acidemia and homocystinuria, differential diagnosis with acquired vitamin B12 deficiency should be done. The results of our strategy support the inclusion of this acquired condition in the NBS programs, as it is easily detectable and allows the adoption of corrective measures to avoid the consequences of its deficiency.
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Affiliation(s)
- Sonia Pajares
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, 08028, Barcelona, Spain.,Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain
| | | | - Aida Ormazabal
- Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain.,Inborn Errors of Metabolism Unit, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Mireia Del Toro
- Unit of Metabolic Diseases, Hospital Vall D'Hebrón, Barcelona, Spain
| | - Ángeles García-Cazorla
- Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain.,Inborn Errors of Metabolism Unit, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Aleix Navarro-Sastre
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, 08028, Barcelona, Spain
| | - Rosa María López
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, 08028, Barcelona, Spain.,Biomedical Research Institute, August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | | | | | - Camila García-Volpe
- Inborn Errors of Metabolism Unit, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jose Manuel González de Aledo-Castillo
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, 08028, Barcelona, Spain
| | - Ana Argudo
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, 08028, Barcelona, Spain
| | - Jose Luís Marín
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, 08028, Barcelona, Spain
| | - Clara Carnicer
- Unit of Metabolic Diseases, Hospital Vall D'Hebrón, Barcelona, Spain
| | - Rafael Artuch
- Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain.,Inborn Errors of Metabolism Unit, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Frederic Tort
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, 08028, Barcelona, Spain.,Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain.,Biomedical Research Institute, August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Laura Gort
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, 08028, Barcelona, Spain.,Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain.,Biomedical Research Institute, August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Rosa Fernández
- Maternal and Child Health Service, Public Health Agency of Catalonia, Health Department, Government of Catalonia, Barcelona, Spain
| | - Judit García-Villoria
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, 08028, Barcelona, Spain.,Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain.,Biomedical Research Institute, August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Antonia Ribes
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica Y Genética Molecular, Hospital Clínic de Barcelona, C/ Mejía Lequerica S/N, Edificio Helios III, 08028, Barcelona, Spain. .,Center for Biomedical Research Network on Rare Diseases (CIBERER), Madrid, Spain. .,Biomedical Research Institute, August Pi I Sunyer (IDIBAPS), Barcelona, Spain.
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Pajares S, López R, Gort L, Argudo-Ramírez A, Marín J, González de Aledo-Castillo J, García-Villoria J, Arranz J, Del Toro M, Tort F, Ugarteburu O, Casellas M, Fernández R, Ribes A. An incidental finding in newborn screening leading to the diagnosis of a patient with ECHS1 mutations. Mol Genet Metab Rep 2020; 22:100553. [PMID: 31908952 PMCID: PMC6940607 DOI: 10.1016/j.ymgmr.2019.100553] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/27/2022] Open
Abstract
Short-chain enoyl-CoA hydratase (ECHS1) is a mitochondrial beta-oxidation enzyme involved in the metabolism of acyl-CoA fatty acid esters, as well as in valine metabolism. ECHS1 deficiency has multiple manifestations, including Leigh syndrome early at birth or in childhood with poor prognosis, to cutis laxa, exercise-induced dystonia and congenital lactic acidosis. Here we describe the case of a newborn with mutations in ECHS1 that caught our attention after the incidental finding of 3-hydroxy-butyryl\3-hydroxy-isobutyryl\malonylcarnitine (C4OH\C3DC) and tiglylcarnitine (C5:1) on blood spot in the newborn screening (NBS) program. Diagnosis was suspected based on the analysis of organic acids on dried urine spot. A moderate increase of 2-methyl-2,3-dihydroxybutyric acid, was detected, which is a known marker of this disease. Exome analysis showed c.404A>G (p.Asn135Ser) mutation in homozygosis in the ECHS1 gene. The child was therefore admitted to the hospital. Initial examination showed little response to auditory stimuli and mild hypertonia of the extremities. Clinical deterioration was evident at 4 months of age, including neurological and cardiac involvement, and the patient died at 5 months of age. This case illustrates how an incidental detection in the NBS Program can lead to the diagnosis ECHS1 deficiency. Although it is a severe disease, with no treatment available, early detection would allow adequate genetic counseling avoiding the odyssey that suffered most of these families.
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Key Words
- 2-methyl-2,3-dihydroxybutyric acid
- 3-hydroxy-butyrylcarnitine\3-hydoxy-isobutyrylcarnitine
- 3MGA, 3-methylglutaconic acid
- C3DC, malonylcarnitine
- C4OH, 3-hydroxy-butyrylcarnitine\3-hydoxy-isobutyrylcarnitine
- C5:1, tiglylcarnitine
- DBS, dried blood spot
- DUS, dried urine spot
- ECHS1 deficiency
- ECHS1, short-chain enoyl-CoA hydratase
- GC, gas chromatography
- HIBCH, 3-hydroxy-isobutyryl-CoA hydrolase
- MRI, magnetic resonance imaging
- MS, mass spectrometry
- Mutations in ECHS1
- NBS, Newborn Screening
- Newborn screening
- PDH, pyruvate dehydrogenase
- TMS, trimethylsilyl
- Tiglylcarnitine
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Affiliation(s)
- S. Pajares
- Section of Inborn Errors of Metabolism, Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, CIBERER, Barcelona, Spain
| | - R.M. López
- Section of Inborn Errors of Metabolism, Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, CIBERER, Barcelona, Spain
| | - L. Gort
- Section of Inborn Errors of Metabolism, Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, CIBERER, Barcelona, Spain
| | - A. Argudo-Ramírez
- Section of Inborn Errors of Metabolism, Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, CIBERER, Barcelona, Spain
| | - J.L. Marín
- Section of Inborn Errors of Metabolism, Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, CIBERER, Barcelona, Spain
| | - J.M. González de Aledo-Castillo
- Section of Inborn Errors of Metabolism, Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, CIBERER, Barcelona, Spain
| | - J. García-Villoria
- Section of Inborn Errors of Metabolism, Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, CIBERER, Barcelona, Spain
| | - J.A. Arranz
- Metabolic Laboratory and Neuropediatric Service, Hospital Universitario Vall de Hebron, Barcelona, Spain
| | - M. Del Toro
- Metabolic Laboratory and Neuropediatric Service, Hospital Universitario Vall de Hebron, Barcelona, Spain
| | - F. Tort
- Section of Inborn Errors of Metabolism, Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, CIBERER, Barcelona, Spain
| | - O. Ugarteburu
- Section of Inborn Errors of Metabolism, Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, CIBERER, Barcelona, Spain
| | - M.D. Casellas
- Pediatric Service, Hospital Universitario Dr. Josep Trueta, Gerona, Spain
| | - R. Fernández
- Public Health Agency, Health Department of Generalitat of Catalonia, Spain
| | - A. Ribes
- Section of Inborn Errors of Metabolism, Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, CIBERER, Barcelona, Spain
- Corresponding author at: Section of Inborn Errors of Metabolism, Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, CIBERER, Barcelona, Spain. c/Mejía Lequerica, s/n, Edificio Helios III, Planta Baja, 080028 Barcelona, Spain.
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Abstract
The scope of newborn screening (NBS) programs is continuously expanding. NBS programs are secondary prevention interventions widely recognized internationally in the "field of Public Health." These interventions are aimed at early detection of asymptomatic children affected by certain diseases, with the objective to establish a definitive diagnosis and apply the proper treatment to prevent further complications and sequelae and ensure a better quality of life. The most significant event in the history of neonatal screening was the discovery of phenylketonuria in 1934. This disease has been the paradigm of inherited metabolic diseases. The next paradigm was the introduction of tandem mass spectrometry in the NBS programs that make possible the simultaneous measurement of several metabolites and consequently, the detection of several diseases in one blood spot and in an unique analysis. We aim to review the current situation of neonatal screening in 2016 worldwide and show scientific evidence of the benefits for some diseases. We will also discuss future challenges. It should be taken into account that any consideration to expand an NBS panel should involve a rigorous process of decision-making that balances benefits against the risks of harm.
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Affiliation(s)
- Judit Garcia Villoria
- From the Seccción de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica y Genética Molecular, Hospital ClinicHospital Clínic, CIBERER, IDIBAPS, Barcelona, Spain
| | - Sonia Pajares
- From the Seccción de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica y Genética Molecular, Hospital ClinicHospital Clínic, CIBERER, IDIBAPS, Barcelona, Spain
| | - Rosa María López
- From the Seccción de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica y Genética Molecular, Hospital ClinicHospital Clínic, CIBERER, IDIBAPS, Barcelona, Spain
| | - José Luis Marin
- From the Seccción de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica y Genética Molecular, Hospital ClinicHospital Clínic, CIBERER, IDIBAPS, Barcelona, Spain
| | - Antonia Ribes
- From the Seccción de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica y Genética Molecular, Hospital ClinicHospital Clínic, CIBERER, IDIBAPS, Barcelona, Spain.
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8
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Pajares S, Arias A, García-Villoria J, Macías-Vidal J, Ros E, de las Heras J, Girós M, Coll MJ, Ribes A. Cholestane-3β,5α,6β-triol: high levels in Niemann-Pick type C, cerebrotendinous xanthomatosis, and lysosomal acid lipase deficiency. J Lipid Res 2015; 56:1926-35. [PMID: 26239048 PMCID: PMC4583089 DOI: 10.1194/jlr.m060343] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 07/22/2015] [Indexed: 01/21/2023] Open
Abstract
Niemann-Pick type C (NPC) is a progressive neurodegenerative disease characterized by lysosomal/endosomal accumulation of unesterified cholesterol and glycolipids. Recent studies have shown that plasma cholestane-3β,5α,6β-triol (CT) and 7-ketocholesterol (7-KC) could be potential biomarkers for the diagnosis of NPC patients. We aimed to know the sensitivity and specificity of these biomarkers for the diagnosis of NPC compared with other diseases that can potentially lead to oxysterol alterations. We studied 107 controls and 122 patients including 16 with NPC, 3 with lysosomal acid lipase (LAL) deficiency, 8 with other lysosomal diseases, 5 with galactosemia, 11 with cerebrotendinous xanthomatosis (CTX), 3 with Smith-Lemli-Opitz, 14 with peroxisomal biogenesis disorders, 19 with unspecific hepatic diseases, 13 with familial hypercholesterolemia, and 30 with neurological involvement and no evidence of an inherited metabolic disease. CT and 7-KC were analyzed by HPLC-ESI-MS/MS as mono-dimethylglycine derivatives. Levels of 7-KC were high in most of the studied diseases, whereas those of CT were only high in NPC, LAL, and CTX patients. Consequently, although CT is a sensitive biomarker of NPC disease, including those cases with doubtful filipin staining, it is not specific. 7-KC is a very unspecific biomarker.
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Affiliation(s)
- Sonia Pajares
- Sección de Errores Congénitos del Metabolismo, Servicio de Bioquímica y Genética Molecular, Institut d’Investigacions Biomèdiques Pi i Sunyer (IDIBAPS), and Ciber Enfermedades Raras (CIBERER) Instituto de Salud Carlos III, Hospital Clinic, Barcelona, Spain
| | - Angela Arias
- Sección de Errores Congénitos del Metabolismo, Servicio de Bioquímica y Genética Molecular, Institut d’Investigacions Biomèdiques Pi i Sunyer (IDIBAPS), and Ciber Enfermedades Raras (CIBERER) Instituto de Salud Carlos III, Hospital Clinic, Barcelona, Spain
| | - Judit García-Villoria
- Sección de Errores Congénitos del Metabolismo, Servicio de Bioquímica y Genética Molecular, Institut d’Investigacions Biomèdiques Pi i Sunyer (IDIBAPS), and Ciber Enfermedades Raras (CIBERER) Instituto de Salud Carlos III, Hospital Clinic, Barcelona, Spain
| | - Judit Macías-Vidal
- Sección de Errores Congénitos del Metabolismo, Servicio de Bioquímica y Genética Molecular, Institut d’Investigacions Biomèdiques Pi i Sunyer (IDIBAPS), and Ciber Enfermedades Raras (CIBERER) Instituto de Salud Carlos III, Hospital Clinic, Barcelona, Spain
| | - Emilio Ros
- Lipid Clinic, Endocrinology and Nutrition Service, IDIBAPS, and Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN) Instituto de Salud Carlos III, Hospital Clinic, Barcelona, Spain
| | - Javier de las Heras
- Division of Pediatric Metabolism, Hospital Universitario de Cruces, Barakaldo, Vizcaya, Spain
| | - Marisa Girós
- Sección de Errores Congénitos del Metabolismo, Servicio de Bioquímica y Genética Molecular, Institut d’Investigacions Biomèdiques Pi i Sunyer (IDIBAPS), and Ciber Enfermedades Raras (CIBERER) Instituto de Salud Carlos III, Hospital Clinic, Barcelona, Spain
| | - Maria J. Coll
- Sección de Errores Congénitos del Metabolismo, Servicio de Bioquímica y Genética Molecular, Institut d’Investigacions Biomèdiques Pi i Sunyer (IDIBAPS), and Ciber Enfermedades Raras (CIBERER) Instituto de Salud Carlos III, Hospital Clinic, Barcelona, Spain
| | - Antonia Ribes
- Sección de Errores Congénitos del Metabolismo, Servicio de Bioquímica y Genética Molecular, Institut d’Investigacions Biomèdiques Pi i Sunyer (IDIBAPS), and Ciber Enfermedades Raras (CIBERER) Instituto de Salud Carlos III, Hospital Clinic, Barcelona, Spain
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Morrone A, Tylee KL, Al-Sayed M, Brusius-Facchin AC, Caciotti A, Church HJ, Coll MJ, Davidson K, Fietz MJ, Gort L, Hegde M, Kubaski F, Lacerda L, Laranjeira F, Leistner-Segal S, Mooney S, Pajares S, Pollard L, Ribeiro I, Wang RY, Miller N. Molecular testing of 163 patients with Morquio A (Mucopolysaccharidosis IVA) identifies 39 novel GALNS mutations. Mol Genet Metab 2014; 112:160-70. [PMID: 24726177 PMCID: PMC4203673 DOI: 10.1016/j.ymgme.2014.03.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 03/11/2014] [Accepted: 03/12/2014] [Indexed: 01/09/2023]
Abstract
Morquio A (Mucopolysaccharidosis IVA; MPS IVA) is an autosomal recessive lysosomal storage disorder caused by partial or total deficiency of the enzyme galactosamine-6-sulfate sulfatase (GALNS; also known as N-acetylgalactosamine-6-sulfate sulfatase) encoded by the GALNS gene. Patients who inherit two mutated GALNS gene alleles have a decreased ability to degrade the glycosaminoglycans (GAGs) keratan sulfate and chondroitin 6-sulfate, thereby causing GAG accumulation within lysosomes and consequently pleiotropic disease. GALNS mutations occur throughout the gene and many mutations are identified only in single patients or families, causing difficulties both in mutation detection and interpretation. In this study, molecular analysis of 163 patients with Morquio A identified 99 unique mutations in the GALNS gene believed to negatively impact GALNS protein function, of which 39 are previously unpublished, together with 26 single-nucleotide polymorphisms. Recommendations for the molecular testing of patients, clear reporting of sequence findings, and interpretation of sequencing data are provided.
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Affiliation(s)
- A Morrone
- Molecular and Cell Biology Laboratory, Pediatric Neurology Unit and Laboratories, Meyer Children's Hospital, Florence, Italy; Department of Neurosciences, Psychology, Pharmacology and Child Health, University of Florence, Florence Italy
| | - K L Tylee
- Willink Biochemical Genetics, Central Manchester University Hospitals NHS Foundation Trust, Saint Mary's Hospital Oxford Road, Manchester, UK
| | - M Al-Sayed
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - A C Brusius-Facchin
- Laboratório de Genética Molecular, Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - A Caciotti
- Molecular and Cell Biology Laboratory, Pediatric Neurology Unit and Laboratories, Meyer Children's Hospital, Florence, Italy
| | - H J Church
- Willink Biochemical Genetics, Central Manchester University Hospitals NHS Foundation Trust, Saint Mary's Hospital Oxford Road, Manchester, UK
| | - M J Coll
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica y Genética Molecular, Hospital Clínic, CIBERER, IDIBAPS, Barcelona, Spain
| | - K Davidson
- BioMarin Pharmaceutical Inc., Novato, CA, USA
| | - M J Fietz
- SA Pathology, Women's and Children's Hospital, North Adelaide, SA, Australia
| | - L Gort
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica y Genética Molecular, Hospital Clínic, CIBERER, IDIBAPS, Barcelona, Spain
| | - M Hegde
- Emory Genetics Laboratory, Emory University School of Medicine, Atlanta, GA, USA
| | - F Kubaski
- Laboratório de Genética Molecular, Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - L Lacerda
- Unidade de Bioquímica Genética, Centro de Genética Médica Jacinto Magalhães (CGMJM) do Centro Hospitalar do Porto (CHP), Porto, Portugal
| | - F Laranjeira
- Unidade de Bioquímica Genética, Centro de Genética Médica Jacinto Magalhães (CGMJM) do Centro Hospitalar do Porto (CHP), Porto, Portugal
| | - S Leistner-Segal
- Laboratório de Genética Molecular, Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - S Mooney
- The Buck Institute for Research on Aging, Novato, CA, USA
| | - S Pajares
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica y Genética Molecular, Hospital Clínic, CIBERER, IDIBAPS, Barcelona, Spain
| | - L Pollard
- Biochemical Genetics Laboratory, Greenwood Genetic Center, Greenwood, SC, USA
| | - I Ribeiro
- Unidade de Bioquímica Genética, Centro de Genética Médica Jacinto Magalhães (CGMJM) do Centro Hospitalar do Porto (CHP), Porto, Portugal
| | - R Y Wang
- Children's Hospital of Orange County, Orange, CA, USA
| | - N Miller
- BioMarin Pharmaceutical Inc., Novato, CA, USA.
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10
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Abstract
Recent investigations have suggested creatine (Cr) as an additional biomarker of mitochondrial diseases. With the aim of corroborating previous findings, we have studied plasma Cr in a cohort of 33 patients with different mitochondrial diseases. Cr was clearly increased in 9 out of 33 patients. Therefore, positive patients represent only 28% of the total number, suggesting that Cr is not a sensitive biomarker of mitochondrial diseases although it does present an acceptable specificity (83%). High plasma Cr, together with other biomarkers, might be useful to reinforce the diagnosis of mitochondrial diseases.
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Affiliation(s)
- Sonia Pajares
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica y Genética Molecular, Hospital Clínic, CIBERER, IDIBAPS, Barcelona, Spain
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11
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Pajares S, Alcalde C, Couce ML, Del Toro M, González-Meneses A, Guillén E, Pineda M, Pintos G, Gort L, Coll MJ. Molecular analysis of mucopolysaccharidosis IVA (Morquio A) in Spain. Mol Genet Metab 2012; 106:196-201. [PMID: 22521955 DOI: 10.1016/j.ymgme.2012.03.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Revised: 03/13/2012] [Accepted: 03/13/2012] [Indexed: 11/21/2022]
Abstract
Mucopolysaccharidosis type IVA (Morquio A) is an inherited metabolic disease with autosomal recessive inheritance. The pathology is due to a deficient activity of N-acetylgalactosamine-6-sulfate-sulfatase, which is involved in the degradation of keratan sulfate and chondroitin-6-sulfate. To date more than 150 mutations have been described in the GALNS gene in different populations. The aim of this study was to analyze the mutations and polymorphisms in Spain in order to know the epidemiology of our population and also to offer genetic counseling to affected families. We found 30 mutant alleles in the 15 families analyzed completing all the genotypes. Most of the mutations that we found were missense mutations, six of which were novel: p.S74F, p.E121D, p.Y254C, p.E260K, p.T394P and p.N495Y; we also found a small deletion (c.1142delC) and a probable deep intronic mutation that causes the loss of exon 5 (c.423_566del) found in cDNA. Both mutations are described in this study for the first time. We also identified 20 polymorphisms previously reported and 2 novel ones: (c.633+222T/C and c.898+25C>G). In conclusion, we have identified the mutations responsible for Mucopolysaccharidosis IV A in Spain. We found great allelic heterogeneity, as occurs in other populations, which hinders the establishment of genotype-phenotype correlations in Spain. This study has been very useful for genetic counseling to the affected families.
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Affiliation(s)
- Sonia Pajares
- Sección de Errores Congénitos del Metabolismo-IBC, Servicio de Bioquímica y Genética Molecular, Hospital Clínic, CIBERER, IDIBAPS, Barcelona, Spain
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Pajares S, González C, Robles O, Casado P, Gómez A, Cuenca C, Ramiro M, Hita L, Villar E, Fernandez R. 185 DUAL-TASK PROGRAM TRAINING IN PATIENTS WITH ACQUIRED BRAIN INJURY. Parkinsonism Relat Disord 2010. [DOI: 10.1016/s1353-8020(10)70186-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Parrón R, Tomé F, Pajares S, Herrera J, Madruga J, Hermida Á, Barriga A. Treatment of Periprosthetic Knee Fractures in the Distal Femur by means of Retrograde Intramedullary Nailing. Rev Esp Cir Ortop Traumatol (Engl Ed) 2007. [DOI: 10.1016/s1988-8856(07)70051-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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