Organic acidurias in Egyptian children: The urge for high-risk screening

Pediatr Int. 2023 Jan;65(1):e15469. doi: 10.1111/ped.15469.

Abstract

Background: Organic acidurias are a group of inborn errors of metabolism. They present a significant diagnostic challenge and are associated with serious morbidity and mortality. They are considered the most frequent inborn errors of metabolism among high-risk children. Gas chromatography-mass spectrometry is a reliable diagnostic technique for organic acidurias. This hospital-based study aimed to quantify the frequency of organic acidurias among a group of high-risk Egyptian pediatric patients and to highlight the importance of high-risk screening for such disorders.

Methods: One hundred and fifty high-risk children who presented to the inherited metabolic disease unit and the pediatric intensive care units of Cairo University Children Hospital were tested for urine organic acids using gas chromatography-mass spectrometry.

Results: Thirty percent (45/150) of the patients were confirmed as having an altered organic acids profile. Neurological manifestations were the most common presentation. Glutaric aciduria type I and maple-syrup urine disease were the most common disorders encountered among the group that was studied.

Conclusion: Organic acid detection by gas chromatography-mass spectrometry is key to the diagnosis of many metabolic disorders. Until a national expanded newborn screening program is established, high-risk screening is strongly encouraged for the early detection of, and proper intervention for such disorders among Egyptian children.

Keywords: high-risk screening; inborn errors of metabolism; mass spectrometry; organic acidurias; pediatric intensive care unit.

MeSH terms

  • Amino Acid Metabolism, Inborn Errors* / diagnosis
  • Child
  • Egypt / epidemiology
  • Gas Chromatography-Mass Spectrometry / methods
  • Humans
  • Infant, Newborn
  • Metabolic Diseases*
  • Neonatal Screening