Newborn tandem mass spectroscopy screening for adenosine deaminase deficiency.


Journal

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
ISSN: 1534-4436
Titre abrégé: Ann Allergy Asthma Immunol
Pays: United States
ID NLM: 9503580

Informations de publication

Date de publication:
12 2022
Historique:
received: 11 03 2022
revised: 15 07 2022
accepted: 20 07 2022
pubmed: 2 8 2022
medline: 7 12 2022
entrez: 1 8 2022
Statut: ppublish

Résumé

Newborn screening (NBS) by means of T cell receptor excision circles (TREC) is now universal in the United States, Puerto Rico, and the Navajo Nation as a strategy to identify severe combined immunodeficiency (SCID) in newborns. Owing to the characteristics of adenosine deaminase (ADA) deficiency, a small but important number of cases can be missed by this screening. To evaluate the results of the first year statewide NBS for ADA by means of dried blood spot NBS. On October 7, 2019, the state of Michigan began screening newborn dried blood spots for ADA deficiency by means of the Neobase-2 tandem mass spectroscopy (TMS) kit. We report 1 known case of ADA deficiency in the 18 months before screening. We then reviewed the results of the first 2 years of TMS ADA screening in Michigan. There was 1 patient with ADA deficiency known to our centers in the 18 months before initiation of TMS ADA screening; this patient died of complications of their disease. In the first 2 years of TMS ADA NBS, 206,321 infants were screened, and 2 patients had positive ADA screen results. Both patients had ADA deficiency confirmed through biochemical and genetic testing. One patient identified also had a positive TREC screen and was confirmed to have ADA-SCID. In our first 2 years, TMS NBS for ADA deficiency identified 2 patients with ADA deficiency at negligible cost, including 1 patient who would not have been identified by TREC NBS. This report provides initial evidence of the value of specific NBS for ADA deficiency.

Sections du résumé

BACKGROUND
Newborn screening (NBS) by means of T cell receptor excision circles (TREC) is now universal in the United States, Puerto Rico, and the Navajo Nation as a strategy to identify severe combined immunodeficiency (SCID) in newborns. Owing to the characteristics of adenosine deaminase (ADA) deficiency, a small but important number of cases can be missed by this screening.
OBJECTIVE
To evaluate the results of the first year statewide NBS for ADA by means of dried blood spot NBS.
METHODS
On October 7, 2019, the state of Michigan began screening newborn dried blood spots for ADA deficiency by means of the Neobase-2 tandem mass spectroscopy (TMS) kit. We report 1 known case of ADA deficiency in the 18 months before screening. We then reviewed the results of the first 2 years of TMS ADA screening in Michigan.
RESULTS
There was 1 patient with ADA deficiency known to our centers in the 18 months before initiation of TMS ADA screening; this patient died of complications of their disease. In the first 2 years of TMS ADA NBS, 206,321 infants were screened, and 2 patients had positive ADA screen results. Both patients had ADA deficiency confirmed through biochemical and genetic testing. One patient identified also had a positive TREC screen and was confirmed to have ADA-SCID.
CONCLUSION
In our first 2 years, TMS NBS for ADA deficiency identified 2 patients with ADA deficiency at negligible cost, including 1 patient who would not have been identified by TREC NBS. This report provides initial evidence of the value of specific NBS for ADA deficiency.

Identifiants

pubmed: 35914665
pii: S1081-1206(22)00610-X
doi: 10.1016/j.anai.2022.07.016
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

776-783.e2

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2022 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Auteurs

Nicholas Hartog (N)

Division of Allergy and Immunology, Helen DeVos Children's Hospital and Spectrum Health, Grand Rapids, Michigan; Michigan State University College of Human Medicine, East Lansing, Michigan. Electronic address: Nicholas.hartog@spectrumhealth.org.

Michael Hershfield (M)

Department of Medicine, Duke University School of Medicine, Durham, North Carolina; Department of Biochemistry, Duke University School of Medicine, Durham, North Carolina.

Thomas Michniacki (T)

Pediatric Hematology, Oncology, and Bone Marrow Transplantation, C.S. Mott Children's Hospital and University of Michigan, Ann Arbor, Michigan.

Shawn Moloney (S)

Michigan Department of Health and Human Services, Warren, Michigan.

Amanda Holsworth (A)

Division of Allergy and Immunology, Helen DeVos Children's Hospital and Spectrum Health, Grand Rapids, Michigan; Michigan State University College of Human Medicine, East Lansing, Michigan.

Isabel Hurden (I)

Michigan Department of Health and Human Services, Warren, Michigan.

Mary Fredrickson (M)

Division of Allergy and Immunology, Children's Hospital of Michigan, Detroit, Michigan.

Mary Kleyn (M)

Michigan Department of Health and Human Services, Warren, Michigan.

Kelly Walkovich (K)

Pediatric Hematology, Oncology, and Bone Marrow Transplantation, C.S. Mott Children's Hospital and University of Michigan, Ann Arbor, Michigan.

Elizabeth Secord (E)

Division of Allergy and Immunology, Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan.

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