Forensic Pathology and Newborn Screening for Inborn Errors of Metabolism: Implications for the Middle East

We report the postmortem findings of two infants and one child who died in Iraq. In each case, a specific clinical diagnosis was never established and all died at home. None of the cases had undergone newborn screening tests for inherited diseases. In case 1, a 3-day old neonate died without ever pa...

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Main Authors: Yazan A. Seulieman, Mustafa Rasool, Zaid Al-Ali, Abdul Ali-Hameed, Amir Jameel, Soledad Martinez, Michael S. Pollanen
Format: Article
Language:Arabic
Published: Naif University Publishing House 2016-12-01
Series:Arab Journal of Forensic Sciences & Forensic Medicine
Subjects:
Online Access:https://journals.nauss.edu.sa/index.php/AJFSFM/article/view/218
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author Yazan A. Seulieman
Mustafa Rasool
Zaid Al-Ali
Abdul Ali-Hameed
Amir Jameel
Soledad Martinez
Michael S. Pollanen
author_facet Yazan A. Seulieman
Mustafa Rasool
Zaid Al-Ali
Abdul Ali-Hameed
Amir Jameel
Soledad Martinez
Michael S. Pollanen
author_sort Yazan A. Seulieman
collection DOAJ
description We report the postmortem findings of two infants and one child who died in Iraq. In each case, a specific clinical diagnosis was never established and all died at home. None of the cases had undergone newborn screening tests for inherited diseases. In case 1, a 3-day old neonate died without ever passing meconium. Autopsy revealed complete small intestinal obstruction due to meconium ileus. This was most likely due to cystic fibrosis. In case 2, a 6 month old boy died suddenly and unexpectedly after developing dehydration from vomiting. Autopsy revealed marked hepatomegaly with fatty infiltration that also involved the myocardium and kidney. This was most likely due to Medium Chain Aacyl Co-A dehydrogenase (MCAD) deficiency. In case 3, a 12-year-old boy died after a progressive neurological disorder of childhood. At autopsy, the body showed cachexia and flexion contractions. The brain showed loss of white matter bulk and thinning of the corpus callosum. The major organs showed no abnormalities. Histologic examination revealed only mild spongy change of the white matter. These findings indicate that the child likely had an organic acidemia, most probably phenylketonuria (PKU). These cases highlight the critical importance of newborn screening for inborn errors of metabolism in Iraq, including laboratory testing for PKU, MCAD deficiency and cystic fibrosis. Such screening can prevent unnecessary morbidity and mortality in infants and children. On this basis, forensic pathologists should advocate for widespread newborn screening in the Middle East.
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spelling doaj.art-8493ec53548c49b7a176e5e7aef3196e2024-03-12T12:28:09ZaraNaif University Publishing HouseArab Journal of Forensic Sciences & Forensic Medicine1658-67861658-67942016-12-011443844210.12816/003313956Forensic Pathology and Newborn Screening for Inborn Errors of Metabolism: Implications for the Middle EastYazan A. SeuliemanMustafa RasoolZaid Al-AliAbdul Ali-HameedAmir JameelSoledad MartinezMichael S. PollanenWe report the postmortem findings of two infants and one child who died in Iraq. In each case, a specific clinical diagnosis was never established and all died at home. None of the cases had undergone newborn screening tests for inherited diseases. In case 1, a 3-day old neonate died without ever passing meconium. Autopsy revealed complete small intestinal obstruction due to meconium ileus. This was most likely due to cystic fibrosis. In case 2, a 6 month old boy died suddenly and unexpectedly after developing dehydration from vomiting. Autopsy revealed marked hepatomegaly with fatty infiltration that also involved the myocardium and kidney. This was most likely due to Medium Chain Aacyl Co-A dehydrogenase (MCAD) deficiency. In case 3, a 12-year-old boy died after a progressive neurological disorder of childhood. At autopsy, the body showed cachexia and flexion contractions. The brain showed loss of white matter bulk and thinning of the corpus callosum. The major organs showed no abnormalities. Histologic examination revealed only mild spongy change of the white matter. These findings indicate that the child likely had an organic acidemia, most probably phenylketonuria (PKU). These cases highlight the critical importance of newborn screening for inborn errors of metabolism in Iraq, including laboratory testing for PKU, MCAD deficiency and cystic fibrosis. Such screening can prevent unnecessary morbidity and mortality in infants and children. On this basis, forensic pathologists should advocate for widespread newborn screening in the Middle East.https://journals.nauss.edu.sa/index.php/AJFSFM/article/view/218forensic scienceforensic pathologynewborn screeningmetabolismmiddle east
spellingShingle Yazan A. Seulieman
Mustafa Rasool
Zaid Al-Ali
Abdul Ali-Hameed
Amir Jameel
Soledad Martinez
Michael S. Pollanen
Forensic Pathology and Newborn Screening for Inborn Errors of Metabolism: Implications for the Middle East
Arab Journal of Forensic Sciences & Forensic Medicine
forensic science
forensic pathology
newborn screening
metabolism
middle east
title Forensic Pathology and Newborn Screening for Inborn Errors of Metabolism: Implications for the Middle East
title_full Forensic Pathology and Newborn Screening for Inborn Errors of Metabolism: Implications for the Middle East
title_fullStr Forensic Pathology and Newborn Screening for Inborn Errors of Metabolism: Implications for the Middle East
title_full_unstemmed Forensic Pathology and Newborn Screening for Inborn Errors of Metabolism: Implications for the Middle East
title_short Forensic Pathology and Newborn Screening for Inborn Errors of Metabolism: Implications for the Middle East
title_sort forensic pathology and newborn screening for inborn errors of metabolism implications for the middle east
topic forensic science
forensic pathology
newborn screening
metabolism
middle east
url https://journals.nauss.edu.sa/index.php/AJFSFM/article/view/218
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