Journal of the Formosan Medical Association
Volume 105, Issue 11 , Pages 882-886, 2006

Tandem Mass Neonatal Screening in Taiwan—Report from One Center

  • Hsiang-Po Huang

      Affiliations

    • Departments of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • Departments of Medical Research, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
  • ,
  • Kai-Lin Chu

      Affiliations

    • Departments of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
  • ,
  • Yin-Hsiu Chien

      Affiliations

    • Departments of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • Departments of Medical Genetics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
  • ,
  • Ming-Lee Wei

      Affiliations

    • Departments of Medical Genetics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
  • ,
  • Shu-Tzu Wu

      Affiliations

    • Departments of Medical Genetics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
  • ,
  • Shiao-Fang Wang

      Affiliations

    • Departments of Medical Genetics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
  • ,
  • Wuh-Liang Hwu

      Affiliations

    • Departments of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • Departments of Medical Genetics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Wuh-Liang Hwu, Department of Pediatrics, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan

Received 6 September 2005; received in revised form 18 January 2006; accepted 2 May 2006.

Article Outline

Background/Purpose

Neonatal screening using tandem mass spectrometry (MS/MS) started in Taiwan in 2000. We evaluated the efficacy of this system by analyzing the frequency of diseases and the outcome of the patients identified.

Methods

Between August 2001 and July 2004, 199,922 neonates were screened for 10 amino acids and acylcarnitines using MS/MS in a single center.

Results

In total, 29 cases of inborn errors of metabolism were detected. The overall prevalence was one per 6894 births. The most common inborn error found was 3-methylcrotonyl CoA carboxylase deficiency (10 cases, 34.5%), but none of the cases needed aggressive treatment. There were two cases of type I glu-taric aciduria, two cases of maple syrup urine disease, and one case of type II citrullinemia, and early therapeutic intervention was effective for all of them.

Conclusion

We found that MS/MS neonatal screening was valuable in the early diagnosis of severe and treatable inborn errors of metabolism such as organic acidemias and urea cycle disorders. It also detected less severe disorders that required only observation.

Key Words:  acylcarnitines , amino acids , inborn errors , neonatal screening , tandem mass

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References 

  1. Millington DS , Kodo N , Norwood DL , et al.   Tandem mass spectrometry: a new method for acylcarnitine profiling with potential for neonatal screening for inborn errors of metabolism . J Inherit Metab Dis . 1990;13:321–324
  2. Baumgartner MR , Almashanu S , Suormala T , et al.   The molecular basis of human 3-methylcrotonyl-CoA carboxy-lase deficiency . J Clin Invest . 2001;107:495–504
  3. Haberle J , Pauli S , Schmidt E , et al.   Mild citrullinemia in Caucasians is an allelic variant of argininosuccinate syn-thetase deficiency (citrullinemia type 1) . Mol Genet Metab . 2003;80:302–306
  4. Wiley V , Carpenter K , Wilcken B . Neonatal screening with tandem mass spectrometry: 12 months' experience in NSW Australia . Acta Pediatri Suppl . 1999;88:48–51
  5. Wilcken B , Wiley V , Hammond J , et al.   Screening neona-tals for inborn errors of metabolism by tandem mass spectrometry . N Engl J Med. . 2003;348:2304–2312
  6. Zytkovicz TH , Fitzgerald EF , Marsden D , et al.   Tandem mass spectrometric analysis for amino, organic, and fatty acid disorders in neonatal dried blood spots: a two-year summary from the New England Neonatal Screening Program . Clin Chem . 2001;47:1945–1955
  7. Schulze A , Lindner M , Kohlmuller D , et al.   Expanded neonatal screening for inborn errors of metabolism by elec-trospray ionizationtandem mass spectrometry: results, outcome, and implications . Pediatrics . 2003;111:1399–1406
  8. Chiang SH , Hsiao YS , Hsiao KJ . Prospective of Neonatal Screening . In:  Lee ML editors. Taiwan Metabolic disorders-Taiwan experiences . Taipei: Ho Chi Book Publishing Co.; 2004;p. 29–58
  9. Lin WD , Wu JY , Lai CC , et al.   A pilot study of neonatal screening by electrospray ionization tandem mass spectro-metry in Taiwan . Acta Paediatr Taiwan . 2001;42:224–230
  10. Rashed MS , Ozand PT , Bucknall MP , et al.   Diagnosis of inborn errors of metabolism from blood spots by acylcar-nitines and amino acids profiling using automated electro-spray tandem mass spectrometry . Pediatr Res. . 1995;38:324–331
  11. Schulze A , Kohlmueller D , Mayatepek E . Sensitivity of electrospraytandem mass spectrometry using the pheny-lalanine/tyrosine-ratio for differential diagnosis of hyper-phenylalaninemia in neonates . Clin Chim Acta . 1999;283:15–20
  12. Gregersen N , Winter V , Curtis D , et al.   Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency: the prevalent mutation G985 (K304E) is subject to a strong founder effect from northwestern Europe . Hum Hered . 1993;43:342–350
  13. Wang SS , Fernhoff PM , Hannon WH , et al.   Medium chain acyl-CoA dehydrogenase deficiency human genome epidemiology review . Genet Med. . 1999;1:332–339
  14. Yeung CY , Lin SP , Kao HA , et al.   Maple syrup urine disease: report of two cases . J Formos Med Assoc . 1993;92:765–768
  15. Shu SG , Tsai CR , Chen LH , et al.   Type I glutaric aciduria: phenotypes and genotypes in 5 Taiwanese children . J Formos Med Assoc . 2003;102:729–732
  16. Lin JF , Chiu PC , Hsu HY , et al.   An early diagnosis leads to a good prognosis: a patient with maple syrup urine disease-screened by tandem mass spectrometry . Acta Paediatr Taiwan . 2004;45:287–289
  17. Wei CC , Lin WD , Tsai FJ , et al.   Isovaleric acidemia diagnosed promptly by tandem mass spectrometry: report of one case . Acta Paediatr Taiwan . 2004;45:236–238

PII: S0929-6646(09)60173-X

doi:10.1016/S0929-6646(09)60173-X

Journal of the Formosan Medical Association
Volume 105, Issue 11 , Pages 882-886, 2006