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Selective screening for inborn errors of metabolism by tandem mass spectrometry in Egyptian children: a 5 year report.
[phenylketonuria]
In
order
to
enhance
awareness
and
promote
registry
for
inborn
errors
of
metabolism
(
IEMs
)
in
Egypt
,
we
aimed
to
evaluate
the
prevalence
and
main
clinical
findings
of
IEMs
detectable
by
tandem
mass
spectrometry
(
MS
/
MS
)
among
high
risk
pediatric
patients
presenting
to
our
tertiary
care
facility
at
Cairo
University
Children
's
Hospital
over
a
period
of
5
years
and
to
compare
the
disease
burden
in
Egypt
in
the
absence
of
a
national
screening
program
for
inherited
metabolic
disorders
with
other
populations
.
During
this
period
3380
Egyptian
children
were
suspected
of
having
IEMs
based
on
clinical
/
laboratory
presentation
and
were
analyzed
by
MS
/
MS
.
Confirmatory
testing
was
performed
according
to
flagged
analyte
by
MS
/
MS
using
a
different
sample
type
such
as
plasma
or
urine
or
by
a
different
technique
such
as
GC
/
MS
.
A
relatively
high
number
of
patients
(
203
/
3380
(
6
%
)
)
were
confirmed
with
17
different
types
of
IEMs
.
Averages
for
age
at
diagnosis
for
different
disorders
ranged
from
2
.
5
months
to
6
.
6
years
with
general
developmental
delay
and
irreversible
neurological
damage
being
the
most
common
presenting
features
(
75
.
9
%
and
65
.
5
%
,
respectively
)
.
Amino
acid
disorders
(
127
/
203
(
62
.
6
%
)
)
,
mainly
phenylketonuria
(
100
/
203
(
49
.
3
%
)
)
,
were
the
most
encountered
,
followed
by
organic
acidemias
(
69
/
203
(
34
%
)
)
,
while
fatty
acid
oxidation
defects
(
7
/
203
(
3
.
4
%
)
)
were
relatively
rare
.
88
%
of
patients
were
born
to
consanguineous
parents
.
The
development
of
a
nationwide
screening
program
for
IEMs
is
mandatory
for
early
detection
of
these
potentially
treatable
disorders
,
prompt
and
properly
timed
therapeutic
intervention
and
prevention
of
the
devastating
neurological
outcomes
.
Diseases
Validation
Diseases presenting
"early detection"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
adrenomyeloneuropathy
allergic bronchopulmonary aspergillosis
carcinoma of the gallbladder
child syndrome
cholangiocarcinoma
classical phenylketonuria
congenital diaphragmatic hernia
cowden syndrome
cystinuria
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal squamous cell carcinoma
fabry disease
homocystinuria without methylmalonic aciduria
inclusion body myositis
kallmann syndrome
krabbe disease
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
pyomyositis
von hippel-lindau disease
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