Jay Allison M, Conway Robert L, Feldman Gerald L, Nahhas Fatimah, Spencer Linda, Wolf Barry
Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan, USA.
1] Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan, USA [2] Center for Molecular Medicine and Genetics, Wayne State University, Detroit, Michigan, USA [3] Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan, USA.
Genet Med. 2015 Mar;17(3):205-9. doi: 10.1038/gim.2014.104. Epub 2014 Aug 21.
Biotinidase deficiency, if untreated, usually results in neurological and cutaneous symptoms. Biotin supplementation markedly improves and likely prevents symptoms in those treated early. All states in the United States and many countries perform newborn screening for biotinidase deficiency. However, there are few studies about the outcomes of the individuals identified by newborn screening.
We report the outcomes of 142 children with biotinidase deficiency identified by newborn screening in Michigan over a 25-year period and followed in our clinic; 22 had profound deficiency and 120 had partial deficiency.
Individuals with profound biotinidase and partial deficiency identified by newborn screening were started on biotin therapy soon after birth. With good compliance, these children appeared to have normal physical and cognitive development. Although some children exhibited mild clinical problems, these are unlikely attributable to the disorder. Biotin therapy appears to prevent the development of neurological and cutaneous problems in our population.
Individuals with biotinidase deficiency ascertained by newborn screening and treated since birth appeared to exhibit normal physical and cognitive development. If an individual does develop symptoms, after compliance and dosage issues are excluded, then other causes must be considered.Genet Med 17 3, 205-209.
生物素酶缺乏症若不治疗,通常会导致神经和皮肤症状。补充生物素可显著改善症状,并可能预防早期接受治疗者出现症状。美国所有州及许多国家都对新生儿进行生物素酶缺乏症筛查。然而,关于通过新生儿筛查确诊的个体的预后研究却很少。
我们报告了密歇根州在25年期间通过新生儿筛查确诊并在我们诊所随访的142例生物素酶缺乏症儿童的预后情况;其中22例为严重缺乏,120例为部分缺乏。
通过新生儿筛查确诊的严重生物素酶缺乏和部分缺乏个体在出生后不久即开始接受生物素治疗。在依从性良好的情况下,这些儿童的身体和认知发育似乎正常。尽管有些儿童出现了轻微的临床问题,但这些问题不太可能归因于该疾病。生物素治疗似乎可预防我们研究人群中神经和皮肤问题的发生。
通过新生儿筛查确诊且自出生起就接受治疗的生物素酶缺乏症个体似乎表现出正常的身体和认知发育。如果个体确实出现症状,在排除依从性和剂量问题后,则必须考虑其他原因。《遗传医学》第17卷第3期,205 - 209页。