Neonates with inborn errors of metabolism: spectrum and short-term outcomes at a tertiary care hospital
Neonates with inborn errors of metabolism: spectrum and short-term outcomes at a tertiary care hospital
Gündüz M, Ünal S, Okur İ, Ayrancı-Sucaklı İ Güzel F, Koç N. Neonates with inborn errors of metabolism: spectrum and short-term outcomes at a tertiary care hospital. Turk J Pediatr 2015; 57: 45-52.We aimed to evaluate the neonates diagnosed as IEM in our neonatal intensive care unit and their outcomes. Among 2994 neonates hospitalized, 51 were diagnosed as IEM (1.7%). Admission complaints were poor feeding, decreased activity, jaundice, seizures, abnormal screening and respiratory problems. Phenylketonuria (11), organic acidemias (8), maple syrup urine disease (5), citrullinemia (5), galactosemia (4), nonketotic hyperglycinemia (4) and tyrosinemia (2) were the most commonly diagnosed IEMs. The follow-up period was 2.5-43 months. Among the 33 neonates followed, 19 had normal development, 9 had developmental delays and 5 had cerebral palsy according to the Guide for Monitoring Child Development. Postnatal age on admission, Apgar score at 5 minutes, being transferred, peritoneal dialysis, cranial ultrasonographic findings, consanguinity and sibling history had significant effects on outcome.Early diagnosis through expanded neonatal screening in countries with high rates of consanguinity, enabling the initiation of early treatment, is essential for achieving low mortality rates and good prognoses
___
- Leonard JV, Morris AA. Diagnosis and early management of inborn errors of metabolism presenting around the time of birth. Acta Paediatr 2006; 95: 6-14.
- Saudubray JM, Nassogne MC, de Lonlay P, Touati G. Clinical approach to inherited metabolic disorders in neonates: an overview. Semin Neonatol 2002; 7: 3–15.
- Champion MP. An approach to the diagnosis of inherited metabolic disease. Arch Dis Child Educ Pract Ed 2010; 95: 40-46.
- Chan DWS, Tan ES, Cleary MA. Neonatal seizures: when to consider and how to investigate for an inborn error of metabolism. Proc Singapore Healthc 2010; 19; 112-123.
- Plouin P, Kaminska A. Neonatal seizures. Handb Clin Neurol 2013; 111: 467-476.
- Seshia SS, Huntsman RJ, Lowry NJ, Seshia M, Yager JY, Sankaran K. Neonatal seizures: diagnosis and management. Zhongguo Dang Dai Er Ke Za Zhi 2011; 13: 81-100.
- Martins AM. Inborn errors of metabolism: a clinical overview. Sao Paulo Med J 1999; 117: 251-265.
- Sharma S, Kumar P, Agarwal R, Kabra M, Deorari AK, Paul VK. Approach to inborn errors of metabolism presenting in the neonate. Indian J Pediatr 2008; 75: 271-276.
- Gupta N, Kabra M. Acute management of sick infants with suspected inborn errors of metabolism. Indian J Pediatr 2011: 78: 854-859.
- Ogier de Baulny H. Management and emergency treatments of neonates with a suspicion of inborn errors of metabolism. Semin Neonatol 2002; 7: 17-26.
- Applegarth DA, Toone JR, Lowry RB. Incidence of inborn errors of metabolism in British Columbia, 1969–1996. Pediatrics 2000; 105: e10
- Schwartz IV, Souza CF, Giugliani R. Treatment of inborn errors of metabolism. J Pediatr (Rio J) 2008; 84: S8-S19.
- Saudubray JM, Sedel F, Walter JH. Clinical approach to treatable inborn metabolic diseases: an introduction. J Inherit Metab Dis 2006; 29: 261-274.
- Ertem IO, Dogan DG, Gok CG, et al. A guide for monitoring child development in low- and middle- income countries. Pediatrics 2008; 121: e581-e589.
- Couce ML, Baña A, Bóveda MD, Pérez-Muñuzuri A, Fernández-Lorenzo JR, Fraga JM. Inborn errors of metabolism in a neonatology unit: impact and long- term results. Pediatr Int 2011; 53: 13-17.
- Tu W, He J, Dai F, Wang X, Li Y. Impact of inborn errors of metabolism on admission in a neonatal intensive care unit—a prospective cohort study. Indian J Pediatr 2012; 79: 494-500.
- Kamate M, Chetal V, Kulgod V, Patil V, Christopher R. Profile of inborn errors of metabolism in a tertiary care centre PICU. Indian J Pediatr 2010; 77: 57-60.
- Jouvet P, Touati G, Lesage F, et al. Impact of inborn errors of metabolism on admission and mortality in a pediatric intensive care unit. Eur J Pediatr 2007; 166: 461-465.
- Schulze A, Lindner M, Kohlmüller D, Olgemöller K, Mayatepek E, Hoffmann GF. Expanded newborn screening for inborn errors of metabolism by electrospray ionization-tandem mass spectrometry: results, outcome, and implications. Pediatrics 2003; 111: 1399-1406.
- Wilson C, Kerruish NJ, Wilcken B, Wiltshire E, Webster D. The failure to diagnose inborn errors of metabolism in New Zealand: the case for expanded newborn screening. N Z Med J 2007; 120: U2727.
- Ozben T. Expanded newborn screening and confirmatory follow-up testing for inborn errors of metabolism detected by tandem mass spectrometry. Clin Chem Lab Med 2013; 51: 157-176.
- Ellaway CJ, Wilcken B, Christodoulou J. Clinical approach to inborn errors of metabolism presenting in the newborn period. J Paediatr Child Health 2002; 38: 511-517.
- Leonard JV, Morris AA. Inborn errors of metabolism around time of birth. Lancet 2000; 356: 583-587.
- Thong MK, Yunus ZM. Spectrum of inherited metabolic disorders in Malaysia. Ann Acad Med Singapore 2008; 37: 66-70.
- Enns GM, Packman S. Diagnosing inborn errors of metabolism in the newborn: clinical features. NeoRev 2001; 2: e183-e191.
- Dagli AI, Zori RT, Heese BA. Testing strategy for inborn errors of metabolism in the neonate. NeoRev 2008; 9: e291-e298.