Al-Jasmi Fatma A, Al-Shamsi Aisha, Hertecant Jozef L, Al-Hamad Sania M, Souid Abdul-Kader
Department of Pediatrics, United Arab Emirates University, Al-Ain, UAE.
Tawam Hospital, Al-Ain, UAE.
JIMD Rep. 2016;28:127-135. doi: 10.1007/8904_2015_512. Epub 2015 Nov 21.
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.
本研究报告了2011年至2014年期间我国新生儿筛查所检测出的先天性代谢缺陷(IEM)。在此期间共诊断出114例患者(55名阿联酋公民和59名居民)。该项目在2013年最为全面(检测了29种IEM)且普遍应用,公民发病率为1/1787。这种相对较高的患病率是由于受影响家庭中近亲结婚频繁(81.5%)所致。以下八种疾病占病例总数的80%:生物素酶缺乏症(55例中有14例)、苯丙酮尿症(55例中有11例)、3-甲基巴豆酰甘氨酸尿症(55例中有9例)、中链酰基辅酶A脱氢酶缺乏症(55例中有4例)、精氨琥珀酸尿症、1型戊二酸尿症、2型戊二酸尿症以及甲基丙二酸单酰辅酶A变位酶缺乏症(各55例中有2例)。对55例患者中的48例(87%)进行了突变分析,共鉴定出33种不同的突变。29种(88%)突变具有临床意义,因此可纳入我们的婚前筛查。除生物素酶缺乏症外,大多数突变是纯合的。生物素酶基因(BTD)突变c.1207T>G(在公民中发现)和c.424C>A(在索马里人中发现)与生物素酶活性检测不到有关。因此,我们地区IEM的高患病率适合进行新生儿和婚前筛查,预计这将阻止大多数此类疾病的发生。