The Timely Needs for Infantile Onset Pompe Disease Newborn Screening—Practice in Taiwan

Pompe disease Newborn screening (NBS) aims at diagnosing patients with infantile-onset Pompe disease (IOPD) early enough so a timely treatment can be instituted. Since 2015, the National Taiwan University NBS Center has changed the method for Pompe disease NBS from fluorometric assay to tandem mass...

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Main Authors: Shu-Chuan Chiang, Yin-Hsiu Chien, Kai-Ling Chang, Ni-Chung Lee, Wuh-Liang Hwu
Format: Article
Language:English
Published: MDPI AG 2020-04-01
Series:International Journal of Neonatal Screening
Subjects:
Online Access:https://www.mdpi.com/2409-515X/6/2/30
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author Shu-Chuan Chiang
Yin-Hsiu Chien
Kai-Ling Chang
Ni-Chung Lee
Wuh-Liang Hwu
author_facet Shu-Chuan Chiang
Yin-Hsiu Chien
Kai-Ling Chang
Ni-Chung Lee
Wuh-Liang Hwu
author_sort Shu-Chuan Chiang
collection DOAJ
description Pompe disease Newborn screening (NBS) aims at diagnosing patients with infantile-onset Pompe disease (IOPD) early enough so a timely treatment can be instituted. Since 2015, the National Taiwan University NBS Center has changed the method for Pompe disease NBS from fluorometric assay to tandem mass assay. From 2016 to 2019, 14 newborns were reported as high-risk for Pompe disease at a median age of 9 days (range 6–13), and 18 were with a borderline risk at a median age of 13 days (9–28). None of the borderline risks were IOPD patients. Among the 14 at a high-risk of Pompe disease, four were found to have cardiomyopathy, and six were classified as potential late-onset Pompe disease. The four classic IOPD newborns, three of the four having at least one allele of the cross-reactive immunologic material (CRIM)-positive variant, started enzyme replacement therapy (ERT) at a median age of 9 days (8–14). Western Blot analysis and whole gene sequencing confirmed the CRIM-positive status in all cases. Here, we focus on the patient without the known CRIM-positive variant. Doing ERT before knowing the CRIM status created a dilemma in the decision and was discussed in detail. Our Pompe disease screening and diagnostic program successfully detected and treated patients with IOPD in time. However, the timely exclusion of a CRIM-negative status, which is rare in the Chinese population, is still a challenging task.
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spelling doaj.art-b5b1177bb538425195dfe33bd26382892023-11-19T20:19:56ZengMDPI AGInternational Journal of Neonatal Screening2409-515X2020-04-01623010.3390/ijns6020030The Timely Needs for Infantile Onset Pompe Disease Newborn Screening—Practice in TaiwanShu-Chuan Chiang0Yin-Hsiu Chien1Kai-Ling Chang2Ni-Chung Lee3Wuh-Liang Hwu4Department of Medical Genetics, National Taiwan University Hospital, Taipei 100, TaiwanDepartment of Medical Genetics, National Taiwan University Hospital, Taipei 100, TaiwanDepartment of Medical Genetics, National Taiwan University Hospital, Taipei 100, TaiwanDepartment of Medical Genetics, National Taiwan University Hospital, Taipei 100, TaiwanDepartment of Medical Genetics, National Taiwan University Hospital, Taipei 100, TaiwanPompe disease Newborn screening (NBS) aims at diagnosing patients with infantile-onset Pompe disease (IOPD) early enough so a timely treatment can be instituted. Since 2015, the National Taiwan University NBS Center has changed the method for Pompe disease NBS from fluorometric assay to tandem mass assay. From 2016 to 2019, 14 newborns were reported as high-risk for Pompe disease at a median age of 9 days (range 6–13), and 18 were with a borderline risk at a median age of 13 days (9–28). None of the borderline risks were IOPD patients. Among the 14 at a high-risk of Pompe disease, four were found to have cardiomyopathy, and six were classified as potential late-onset Pompe disease. The four classic IOPD newborns, three of the four having at least one allele of the cross-reactive immunologic material (CRIM)-positive variant, started enzyme replacement therapy (ERT) at a median age of 9 days (8–14). Western Blot analysis and whole gene sequencing confirmed the CRIM-positive status in all cases. Here, we focus on the patient without the known CRIM-positive variant. Doing ERT before knowing the CRIM status created a dilemma in the decision and was discussed in detail. Our Pompe disease screening and diagnostic program successfully detected and treated patients with IOPD in time. However, the timely exclusion of a CRIM-negative status, which is rare in the Chinese population, is still a challenging task.https://www.mdpi.com/2409-515X/6/2/30infantile-onset Pompe diseaseGAA sequencingimmune modulation therapyenzyme replacement therapycross-reactive immunologic material
spellingShingle Shu-Chuan Chiang
Yin-Hsiu Chien
Kai-Ling Chang
Ni-Chung Lee
Wuh-Liang Hwu
The Timely Needs for Infantile Onset Pompe Disease Newborn Screening—Practice in Taiwan
International Journal of Neonatal Screening
infantile-onset Pompe disease
GAA sequencing
immune modulation therapy
enzyme replacement therapy
cross-reactive immunologic material
title The Timely Needs for Infantile Onset Pompe Disease Newborn Screening—Practice in Taiwan
title_full The Timely Needs for Infantile Onset Pompe Disease Newborn Screening—Practice in Taiwan
title_fullStr The Timely Needs for Infantile Onset Pompe Disease Newborn Screening—Practice in Taiwan
title_full_unstemmed The Timely Needs for Infantile Onset Pompe Disease Newborn Screening—Practice in Taiwan
title_short The Timely Needs for Infantile Onset Pompe Disease Newborn Screening—Practice in Taiwan
title_sort timely needs for infantile onset pompe disease newborn screening practice in taiwan
topic infantile-onset Pompe disease
GAA sequencing
immune modulation therapy
enzyme replacement therapy
cross-reactive immunologic material
url https://www.mdpi.com/2409-515X/6/2/30
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