Mohamed A Elmonem1,2,3, Iman G Mahmoud4,5, Dina A Mehaney6,4, Sahar A Sharaf6,4, Sawsan A Hassan4,7, Azza Orabi4,5, Fadia Salem4,7, Marian Y Girgis4,5, Amira El-Badawy4,5, Magy Abdelwahab8, Zeinab Salah9, Neveen A Soliman10,11, Fayza A Hassan6,4, Laila A Selim4,5. 1. Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt. mohamed.abdelmonem@kasralainy.edu.eg. 2. Inherited Metabolic Disease Unit (IMDU), Cairo University Children's Hospital, Cairo, Egypt. mohamed.abdelmonem@kasralainy.edu.eg. 3. Clinical and Chemical Pathology Department, Inherited Metabolic Disease Laboratory, Faculty of Medicine, Cairo University, 2 Ali Pasha Ibrahim Street, Center of Social and Preventive Medicine, Room 409, Monira, Cairo, 11628, Egypt. mohamed.abdelmonem@kasralainy.edu.eg. 4. Inherited Metabolic Disease Unit (IMDU), Cairo University Children's Hospital, Cairo, Egypt. 5. Department of Pediatric Neurology, Faculty of Medicine, Cairo University, Cairo, Egypt. 6. Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt. 7. Department of Pediatric Genetics, Faculty of Medicine, Cairo University, Cairo, Egypt. 8. Department of Pediatric Hematology, Faculty of Medicine, Cairo University, Cairo, Egypt. 9. Department of Pediatric Cardiology, Faculty of Medicine, Cairo University, Cairo, Egypt. 10. Center for Pediatric Nephrology and Transplantation (CPNT), Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt. 11. Egyptian Group of Orphan Renal Diseases (EGORD), Cairo, Egypt.
Abstract
OBJECTIVE: To describe the spectrum, relative prevalence and molecular background of lysosomal storage disorders in Egypt. METHODS: The authors evaluated the selective screening program for the diagnosis of lysosomal storage disorders in Egyptian children presenting to the inherited metabolic disease unit at Cairo University Children's Hospital, the largest tertiary care pediatric hospital in Egypt, over a six-year period (April 2008 through April 2014). During this period, 1,065 suspected children were assessed clinically, biochemically and some genetically. RESULTS: Two hundred and eleven children (aged 44 ± 32 mo; 56 % boys, 82 % with consanguineous parents) were confirmed with 21 different lysosomal disorders. The diagnostic gap ranged between 2 mo and 14 y (average 25 mo). Mucopolysaccharidoses were the most common group of diseases diagnosed (44.5 %), while Maroteaux-Lamy, Gaucher and nephropathic cystinosis were the most commonly detected syndromes (17.1, 14.7 and 13.7 %, respectively). Eighty mutant alleles and 17 pathogenic mutations were detected in 48 genetically assessed confirmed patients (30 Gaucher, 16 cystinosis and two Niemann-Pick type C patients). CONCLUSIONS: This report is the first to describe relative frequency and spectrum of clinical and molecular data in a large cohort of Egyptian lysosomal patients. The crude estimate denotes that over 80 % of Egyptian lysosomal patients do not have access to optimal diagnosis. Upgrading diagnostic and genetic services for lysosomal storage disorders in Egypt is absolutely necessary.
OBJECTIVE: To describe the spectrum, relative prevalence and molecular background of lysosomal storage disorders in Egypt. METHODS: The authors evaluated the selective screening program for the diagnosis of lysosomal storage disorders in Egyptian children presenting to the inherited metabolic disease unit at Cairo University Children's Hospital, the largest tertiary care pediatric hospital in Egypt, over a six-year period (April 2008 through April 2014). During this period, 1,065 suspected children were assessed clinically, biochemically and some genetically. RESULTS: Two hundred and eleven children (aged 44 ± 32 mo; 56 % boys, 82 % with consanguineous parents) were confirmed with 21 different lysosomal disorders. The diagnostic gap ranged between 2 mo and 14 y (average 25 mo). Mucopolysaccharidoses were the most common group of diseases diagnosed (44.5 %), while Maroteaux-Lamy, Gaucher and nephropathic cystinosis were the most commonly detected syndromes (17.1, 14.7 and 13.7 %, respectively). Eighty mutant alleles and 17 pathogenic mutations were detected in 48 genetically assessed confirmed patients (30 Gaucher, 16 cystinosis and two Niemann-Pick type C patients). CONCLUSIONS: This report is the first to describe relative frequency and spectrum of clinical and molecular data in a large cohort of Egyptian lysosomal patients. The crude estimate denotes that over 80 % of Egyptian lysosomal patients do not have access to optimal diagnosis. Upgrading diagnostic and genetic services for lysosomal storage disorders in Egypt is absolutely necessary.
Entities:
Keywords:
Egyptian children; Enzymatic diagnosis; Genetic testing; Inborn errors of metabolism; Lysosomal storage disorders; Tandem mass spectrometry
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