RESUMEN

Los errores innatos del metabolismo son un grupo muy heterogéneo de enfermedades congénitas, determinadas por el bloqueo de un paso metabólico debido a la mutación de genes responsables del funcionamiento del mismo. Con herencia autosómico recesiva y en algunos casos ligada al cromosoma X, su diagnóstico precoz y el uso correcto de todas las opciones terapéuticas posibles es fundamental para asegurar la supervivencia y la mejor calidad de vida posible de los individuos afectados. El objetivo fue describir los resultados del programa de detección de errores innatos del metabolismo durante cinco años en el municipio Minas de Matahambre. Se realizó un estudio descriptivo y retrospectivo en el municipio de Minas de Matahambre del 2008 al 2012, al total de recién nacidos estudiados mediante el tamizaje neonatal. Se estudiaron un total de 1822 recién nacidos, alcanzando una cobertura del 99,3 por ciento. Existe mayor número de primeras determinaciones de: galactosa y 17 hidroxiprogesterona, no se han detectado casos confirmados de enfermos de hiperplasia adrenal congénita, fenilcetonuria, galactosemia, déficit de biotinidasa e hipotiroidismo congénito. Con el presente trabajose describen los resultados del programa de detecci ón de errores innatos del metabolismo en el municipio, lo que permite el diagnóstico preciso, el correcto tratamiento médico y un adecuado asesoramiento genético a la familia(AU)

Innate errors of metabolism are a very heterogeneous group of congenital diseases, determined by the blocking a metabolic passing due to mutation of genes responsible for the operation. Autosomal recessive inheritance and in some cases X-linked, early diagnosis and proper use of all possible treatment options is critical to assure the survival and the best possible quality of life of affected individuals. The objective was to describe the results of the screening program of innate errors of metabolism for five years in the town of Minas de Matahambre. A retrospective descriptive study was conducted in the town of Minas de Matahambre from 2008 to 2012; the total number of infants were studied by neonatal screening. A total of 1822 infants were studied, reaching coverage of 99.3 per cent. There is a greater number of first determinations: galactose and 17 hydroxyprogesterone were not detected in patients with confirmed congenital adrenal hyperplasia, phenylketonuria, galactosemia, biotinidase deficiency and congenital hypothyroidism cases. The present work program results in detection of innate errors of metabolism in the town as being described, allowing accurate diagnosis, proper medical treatment and appropriate genetic counseling for the family(AU)

Asunto(s)

Asunto(s)

RESUMEN

From 1988 to 1995, our laboratory at the Institute of Chemistry of the Federal University of Rio de Janeiro, in Rio de Janeiro, screened 2650 samples from 2000 high-risk patients (mostly children) for Inborn Errors of Metabolism (IEM). Chemical tests, various chromatographic techniques and enzyme assays were performed on urine, plasma and in some cases, cerebrospinal fluid (CSF). A total of 145 cases of IEM (7.2%) was identified. These were related to: the metabolism of amino acids (41) and carbohydrates (17), organic acids (7), lysosomal enzymes (61), membrane transport system (16), metals (2), intestinal disaccharidases (1) and porphyrin metabolism (3). Furthermore, a relevant number of patients with abnormal findings is still under investigation. Biochemical results and clinical symptoms are presented and the importance of reference laboratories for the detection of IEM is stressed.

Asunto(s)

RESUMEN

UNLABELLED: The number of diagnosed inborn errors of metabolism (IEM) is growing constantly due to the improvement and widespread availability of analytical techniques. In 1982, a laboratory for the detection of IEM was set up in Porto Alegre, Brazil, and became a national reference centre for the diagnosis of these disorders. Ten thousand patients with signs and symptoms suggestive of IEM were investigated in our laboratory from 1982 to 1995 using specific protocols which included tests for the detection of glucosaminoglycans (GAGS), amino acids, sugars, oligosaccharides, sialyloligosaccharides, organic acids, as well as various metabolite. The biochemical investigation was completed in 9,901 patients and an IEM was detected in 647 cases (6.5%). Groups of IEM of higher incidence in our sample were lysosomal storage disorders (59.8%) and aminoacidopathies (21.2%). The disorders most frequently diagnosed were classical phenylketonuria, GM1 gangliosidosis, mucopolysaccharidosis type I, mucopolysaccharidosis type VI and metachromatic leukodystrophy. CONCLUSION: This study shows that the establishment of reference centres for the investigation of rare genetic diseases is a suitable approach to the study of IEM in developing countries such as Brazil.

Asunto(s)

RESUMEN

Las pruebas de tamiz neonatal sirven para detectar a recién nacidos portadores de alguna patología endocrina, infecciosa o errores del metabolismo, antes de que la enfermedad se manifieste y previene, de ser posible, alguna discapacidad física, mental o la muerte. Se considera conveniente establecer un programa nacional de tamiz neonatal e infantil en México y en Latinoamérica, para hipotiroidismo congénito y evaluar la posibilidad de incluir a la hiperplasia adrenal congénita la toxoplasmosis congénita y el neuroblastoma mediante estudios piloto, que consideren un estricto control de calidad, sistemático y automatizado. El costo/beneficio del tamiz neonatal es positivo a la sociedad y evita el daño cerebral permanente, y/o la muerte de los niños

Asunto(s)

RESUMEN

Muitas doenças metabólicas têm uma apresentaçäo aguda que coloca o paciente em risco de vida. Algumas vezes o paciente deteriora rapidamente e evolui para óbito antes que um diagnóstico definitivo seja alcançado. No caso de uma doença genética, o diagnóstico é importante näo apenas para o paciente mas também para a sua família, uma vez que será essencial para as medidas preventivas (detecçäo de portadores, aconselhamento genético, diagnóstico pré-natal) a serem adotadas. Uma vez que o diagnóstico definitivo depende da coleta de amostras apropriadas e, sendo o tempo muitas vezes crítico, neste artigo säo apresentadas algumas instruçöes para a coleta em situaçäo de emergência de amostras de pacientes agudamente enfermos nos quais se suspeita de uma doença metabólica

Asunto(s)

RESUMEN

We screened 81,243 infants born in Virginia during the 1-year period beginning Jan. 24, 1984, for deficiency of the enzyme biotinidase. A simple colorimetric screening procedure was used to detect the presence or absence of biotinidase activity on the same blood-soaked filter paper cards that are currently used in most neonatal metabolic screening programs. Two newborn infants with biotinidase deficiency were identified during the 12-month pilot study. In addition, two affected siblings of one of the newborn infants were detected through secondary family screening. On the basis of these results, the disorder appears to be at least as frequent as several others for which newborn screening is currently conducted. There were no known false-negative test results, and only 0.09% false-positive results that necessitated requests for second blood samples. False-positive test results can be readily identified by the use of a quantitative assay, which can also be used to confirm the diagnosis and to detect heterozygous family members in the case of true positives. On the basis of currently recognized criteria, biotinidase deficiency should be considered for inclusion among the metabolic disorders for which screening is performed in the neonatal period.

Asunto(s)

Asunto(s)

RESUMEN

Seven infants in one kindred died: one was stillborn; the others, who were floppy at birth and were breast-fed, developed a disorder with the odor of sweaty feet and died in early infancy. In two further pregnancies, 3-hydroxvisovaleric, glutaric, and C6-C10-dicarboxylic acids were demonstrated in the mother's urine during the seventh month. Riboflavin therapy in the last trimester of pregnancy and a riboflavin-rich diet given the infants prevented this syndrome. The presence of abnormal erythrocyte glutathione-reductase activity in the mother while she excreted normal amounts of riboflavin in her urine indicates a probable disorder of riboflavin metabolism resulting in multiple acyl-CoA dehydrogenase deficiency.

Asunto(s)

Asunto(s)

Asunto(s)