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接受乳糖激发试验的筛查阳性患者中的半乳糖血症:新生儿筛查项目记录回顾

Galactosemia among Positive-screened Patients who Underwent Lactose Challenge: A Review of Records of the Newborn Screening Program.

作者信息

Orteza Mary Erika V, Abacan Mary Ann R

机构信息

Section of Clinical and Metabolic Genetics, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila.

出版信息

Acta Med Philipp. 2024 Oct 15;58(18):56-63. doi: 10.47895/amp.vi0.8179. eCollection 2024.

Abstract

BACKGROUND

Newborns screened positive for Galactosemia through Expanded Newborn Screening (ENBS) with borderline levels undergo lactose challenge that requires interruption of breastfeeding temporarily then shifting to soy-based formula.

OBJECTIVE

To determine the percentage of Classical Galactosemia (CGal), Non-classical Galactosemia (NCGal), probable mild variant form, and negative Galactosemia among newborns screened positive for Galactosemia who underwent lactose challenge.

METHODS

This is a retrospective study. NBS records were reviewed and data were collected from January 2015 to December 2020.

RESULTS

Out of the 117 newborns screened positive for Galactosemia, 58 underwent lactose challenge. Majority were male, term with a birth weight of 2500-4000g and received a final disposition in 4-6 months. Fifteen patients underwent 1-week lactose challenge wherein six reached a resolution on first challenge. Majority, 35 (60.3%) were negative for Galactosemia, six (10.3%) probable mild variant Galactosemia, three (5.2%) NCGal, and no CGal were observed. Fourteen suspected cases (24.1%) are pending final disposition.

CONCLUSION

This study describes the demographics of newborns flagged for Galactosemia who underwent lactose challenge. A 1-week lactose challenge may be recommended to further detect patients who are negative for Galactosemia.

摘要

背景

通过扩大新生儿筛查(ENBS)筛查出半乳糖血症呈临界水平阳性的新生儿需进行乳糖激发试验,这需要暂时中断母乳喂养,然后改用大豆配方奶粉。

目的

确定在接受乳糖激发试验的半乳糖血症筛查呈阳性的新生儿中,经典半乳糖血症(CGal)、非经典半乳糖血症(NCGal)、可能的轻度变异型和半乳糖血症阴性的比例。

方法

这是一项回顾性研究。回顾了新生儿筛查记录,并收集了2015年1月至2020年12月的数据。

结果

在117例半乳糖血症筛查呈阳性的新生儿中,58例接受了乳糖激发试验。大多数为男性,足月儿,出生体重2500 - 4000g,在4 - 6个月时得到最终诊断。15例患者接受了为期1周的乳糖激发试验,其中6例在首次激发试验时得到解决。大多数,35例(60.3%)半乳糖血症阴性,6例(10.3%)可能为轻度变异型半乳糖血症,3例(5.2%)为NCGal,未观察到CGal。14例疑似病例(24.1%)的最终诊断待定。

结论

本研究描述了接受乳糖激发试验的半乳糖血症标记新生儿的人口统计学特征。建议进行为期1周的乳糖激发试验,以进一步检测半乳糖血症阴性的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b23/11522362/b4dcb535a69d/AMP-58-18-8179-g001.jpg

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