International working group identifies need for newborn screening for mucopolysaccharidosis type I but states that existing hurdles must be overcome.

Rossella Parini, Alexander Broomfield, Maureen A Cleary, Linda De Meirleir, Maja Di Rocco, Waseem M Fathalla, Nathalie Guffon, Christina Lampe, Allan M Lund, Maurizio Scarpa, Anna Tylki-Szymańska, Jiří Zeman

Journal: Acta paediatrica (Oslo, Norway : 1992) 2019;107(12):2059-2065

PMID: 30242902

Abstract

AIM

Mucopolysaccharidosis type I is a lysosomal storage disorder that can result in significant disease burden, disability and premature death, if left untreated. The aim of this review was to elaborate on the diagnosis of mucopolysaccharidosis type I and the pros and cons of newborn screening.

METHODS

An international working group was established to discuss ways to improve the early diagnosis of mucopolysaccharidosis type I. It consisted of 13 experts in paediatrics, rare diseases and inherited metabolic diseases from Europe and the Middle East.

RESULTS

It is becoming increasingly clearer that the delay between symptom onset and clinical diagnosis is considerable for mucopolysaccharidosis type I and other rare lysosomal storage disorders, despite numerous awareness campaigns since therapies became available. Diagnosis currently depends on recognising the signs and symptoms of the disease. The practice of newborn screening, which is being explored by pilot programmes around the world, enables early diagnosis and consequently early treatment. However, these studies have highlighted numerous new problems and pitfalls that must be faced before newborn screening becomes generally available.

CONCLUSION

Newborn screening for mucopolysaccharidosis type I offers the potential for early diagnosis and early pre-symptomatic treatment, but existing hurdles need to be overcome.

©2018 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

Address: Rare Metabolic Diseases Unit, Paediatric Clinic, MBBM Foundation, San Gerardo University Hospital, Monza, Italy.; TIGET Institute, IRCCS San Raffaele Hospital, Milano, Italy.; Willink Biochemical Genetics Unit, Manchester Centre for Genomic Medicine, St Mary's Hospital, Central Manchester Foundation Trust, Manchester, UK.; Metabolic Unit, Great Ormond Street Hospital NHS Trust, London, UK.; Department of Pediatric Neurology and Metabolic Diseases, UZ Brussel, Brussels, Belgium.; Unit of Rare Diseases, Department of Pediatrics, IRCCS Giannina Gaslini, Genova, Italy.; Division of Paediatric Neurology, Department of Paediatrics, Mafraq Hospital, Abu Dhabi, UAE.; Reference Centre of Metabolic Diseases, HFME Hospital, Bron, France.; Children's Hospital, University Medical Center, Johannes Gutenberg University, Mainz, Germany.; Centre for Inherited Metabolic Diseases, Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.; Department of Pediatrics, University of Padova, Padova, Italy.; Department of Paediatrics, Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, Warsaw, Poland.; Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General Faculty Hospital, Prague, Czech Republic.
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