Galactosemia Screening with Low False-Positive Recall Rate: The Swedish Experience
| Autor: | Ulrika von Döbeln, Claes Guthenberg, Annika Ohlsson |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
congenital
hereditary and neonatal diseases and abnormalities Pediatrics medicine.medical_specialty Newborn screening Urea cycle disorder business.industry Galactosemia nutritional and metabolic diseases Disease medicine.disease Article eye diseases Premature ovarian failure False positive paradox Medicine Galactosemia screening Congenital adrenal hyperplasia business |
| Zdroj: | JIMD Reports ISBN: 9783642247576 |
| DOI: | 10.1007/8904_2011_59 |
| Popis: | Newborn screening was implemented in the 1960s with screening for phenylketonuria (PKU). In the same decade, it became possible to screen for classical galactosemia, a rare autosomal recessive inherited disorder, which is potentially life threatening if not treated. While newborn screening for PKU has become almost universal, galactosemia is included only in a minority of European newborn screening programs. The major arguments why galactosemia is excluded from newborn screening programs are that the disease can be diagnosed clinically, there is a high rate of false positives and long-term complications are common despite early diagnosis.Here, we report how we have decreased the number of false-positive galactosemia recalls to less than 0.01%, using a two-tier test strategy. All samples are tested with the Beutler blood spot test, a method that measures galactose-1-phosphate uridyltransferase activity. Samples with less than ≤15% activity are tested for galactose with a galactose dehydrogenase test (the rapid GAL-DH test), which catalyzes the oxidation of galactose and the reduction of NAD(+) to NADH that is estimated visually by fluorescence under UV-light. Both tests are semiquantitative.With this strategy, screening for galactosemia is inexpensive, does not demand a heavy workload, and has a low false-positive re-call rate. The incidence of classical galactosemia in Sweden is 1/100,000, which is lower than the reported incidence in other European countries. Despite this, newborn screening for galactosemia has never been questioned. Concise sentence: Screening for galactosemia using well-established methods to reduce the false-positive rate. |
| Databáze: | OpenAIRE |
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