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Expanded newborn screening program in Slovenia using tandem mass spectrometry and confirmatory next generation sequencing genetic testing Cover

Expanded newborn screening program in Slovenia using tandem mass spectrometry and confirmatory next generation sequencing genetic testing

Open Access
|Oct 2020

Figures & Tables

Figure 1

Screening algorithm for expanded NBS results.

Figure 2

A – all samples (15,064); percentage of negative results compared to others (positive and borderline positive results and rejected samples). B – others – positive and borderline positive results and rejected samples (321); percentage among others (positive and borderline positive results and rejected samples).

Panel of 72 genes for the NGS confirmatory testing in expanded NBS program_

ABCD1ABCD4ACAD8ACAD9ACADLACADMACADSACADVL
ACAT1ADAALDH18A1ARG1ASLASSAUHBCAT2
BCKDHABCKDHBBTDCD320CPS1CPT1ACPT2DBT
DLDETFAETFBETFDHETHE1FAHGCDHGCH1
GLULHADHHADHAHADHBHLCSHMGCLHMGCS2HPD
HSD17B10IVDLMBRD1MCCC1MCCC2MLYCDMMAAMMAB
MMACHCMMADHCMTRMTRRMMUTNAGSOTCPAH

Values of acylcarnitines and amino acids at newborn screening and follow-up for confirmed patients_ CoA – coenzyme A, DBS – dried blood spot, NBS – newborn screening, ref_ – reference_

Module nameNBS results (from DBS) μmol/LFollow-up (from DBS) μmol/LConfirmation tests
Very long-chain acyl-CoA dehydrogenase deficiencyC14:1: 3.41 (˂0.32) C14: 1.41 (˂0.42) C14:2: 0.44 (0–0.05) C14:1/C2: 0.200 (˂0.014) C14:1/C16: 0.84 (˂0.08)C14:1: 0.84 (˂0.32) C14: 0.41 (˂0.42)C14:2: 0.18 (˂0.05) C14:1/C2: 0.090 (˂0.014) C14:1/C16: 0.31 (˂0.08)One known heterozygous pathogenic variant and one likely pathogenic variant

Isovaleric acidemiaC5: 2.47 (˂0.28) C5/C0: 0.132 (˂0.018) C5/C2: 0.164 (˂0.017) C5/C3: 1.91 (˂0.21)C5: 5.77 (˂0.28) C5/C0: 0.222 (˂0.018) C5/C2: 0.499 (˂0.017) C5/C3: 5.84 (˂0.21)Elevated isovalerylglycine in urine Reduced enzyme activity: 0.1 nmol/(min mg prot) (ref. value: 0.94–1.94)

Medium-chain acyl-CoA dehydrogenase deficiencyC8: 0.27 (˂0.16) C6: 0.27 (˂0.12) C10: 0.11 (˂0.26) C10:1: 0.13 (˂0.09) C8/C10: 2.45 (˂1.50) C8/C2: 0.07 (0.01)C8: 0.96 (˂0.27) C6: 0.477 (˂0.15) C10: 0.14 (˂0.32) C10:1: 0.285 (˂0.25) C8/C10: 6.8 (˂2.3) C8/C2: 0.07 (0.02)One known heterozygous pathogenic variant and one variant of unknown significance Reduced enzyme activity: 0.20 nmol/(min mg prot) (ref. value: 0.43–1.63)

HyperprolinemiaProline: 623 (˂261)Proline: 794 (˂441)Two pathogenic variants.Elevated proline in plasma: 748 (110–417) μmol/L

List of diseases included in expanded NBS program_ * – already running newborn screening program for phenylketonuria; in agreement, the program is running in parallel for two years on both systems, and the reported results are from the existing program for PKU screening_

Tyrosinemia type 1Carnitine palmitoyltransferase deficiency type 2
Maple syrup urine disease3-methylcrotonyl-CoA carboxylase deficiency
Isovaleric acidemia3-hydroxy-3-methylglutaric aciduria
Glutaric aciduria type 1Holocarboxylase synthethase deficiency
Glutaric aciduria type 2β-ketothiolase deficiency
Propionic aciduriaVery long-chain acyl-CoA dehydrogenase deficiency
Methylmalonic aciduriaLong-chain 3-hydroxyacyl-CoA dehydrogenase deficiency
Carnitine uptake deficiencyMedium-chain acyl-CoA dehydrogenase deficiency
Carnitine palmitoyltransferase deficiency type 1Phenylketonuria*
DOI: https://doi.org/10.2478/sjph-2020-0032 | Journal eISSN: 1854-2476 | Journal ISSN: 0351-0026
Language: English
Page range: 256 - 263
Submitted on: Apr 17, 2020
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Accepted on: Sep 17, 2020
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Published on: Oct 18, 2020
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2020 Barbka Repič Lampret, Žiga Iztok Remec, Ana Drole Torkar, Mojca Žerjav Tanšek, Andraz Šmon, Vanesa Koračin, Vanja Čuk, Daša Perko, Blanka Ulaga, Ana Marija Jelovšek, Maruša Debeljak, Jernej Kovač, Tadej Battelino, Urh Grošelj, published by National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.