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Newborn screening for severe T and B cell lymphopenia identifies a fraction of patients with Wiskott-Aldrich syndrome.
[wiskott-aldrich syndrome]
The
lack
or
marked
reduction
of
recently
formed
T
and
B
cells
provides
a
basis
for
neonatal
screening
for
severe
combined
immunodeficiencies
(
SCID
)
and
X-
linked
agammaglobulinemia
(
XLA
)
.
Newborns
with
other
conditions
are
also
identified
if
a
severe
T
or
B
cell
lymphopenia
is
present
at
birth
.
We
retrospectively
analyzed
Guthrie
card
samples
from
11
children
with
Wiskott-
Aldrich
syndrome
(
WAS
)
,
a
rare
disease
that
requires
early
diagnosis
and
treatment
,
to
determine
whether
combined
T
-
cell
receptor
excision
circle
(
TREC
)
and
kappa-deleting
recombination
excision
circle
(
KREC
)
screening
could
identify
these
patients
.
4
of
11
patients
showed
markedly
reduced
TREC
or
KREC
copy
numbers
in
their
DBS
as
compared
to
storage-time
matched
controls
and
prospectively
screened
Swedish
and
German
newborns
.
No
correlation
was
observed
between
the
WAS
gene
mutations
,
the
clinical
severity
/
course
and
the
result
of
the
screening
assay
.
A
diagnosis
of
WAS
should
thus
be
considered
in
newborns
with
positive
TREC
or
KREC
screening
results
.
Diseases
Validation
Diseases presenting
"marked reduction"
symptom
coats disease
gm1 gangliosidosis
megacystis-microcolon-intestinal hypoperistalsis syndrome
severe combined immunodeficiency
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
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