The outcome of 41 Late-Diagnosed Turkish GA-1 Patients: A Candidate for the Turkish NBS

Abstract

Background Glutaric aciduria type 1(GA-1) is an inherited cerebral organic aciduria. Untreated patients with GA-1 have a risk of acute encephalopathic crises during the first 6 years of life. In so far as GA-1 desperately does not exist in Turkish newborn screening (NBS) program, most patients in our study were late-diagnosed.

Method This study included 41 patients diagnosed with acylcarnitine profile, urinary organic acids, mutation analyses in the symptomatic period. We presented with clinical, neuroradiological, and molecular data of our 41 patients.

Results The mean age at diagnosis was 14.8 ± 13.9 (15 days to 72 months) and, high blood glutaconic acid, glutarylcarnitine and urinary glutaric acid (GA) levels in 41 patients were revealed. Seventeen different mutations in the glutaryl-CoA dehydrogenase gene were identified, five of which were novel. The patients, most of whom were late-diagnosed, had a poor neurological outcome. Treatment strategies made a little improvement in dystonia and the frequency of encephalopathic attacks.

Conclusion All GA-1 patients in our study were severely affected since they were late-diagnosed, while others show that GA-1 is a treatable metabolic disorder if it is diagnosed with NBS. This study provides an essential perspective of the severe impact on GA-1 patients unless it is diagnosed with NBS. We immediately advocate GA-1 to be included in the Turkish NBS.

Keywords

glutaric aciduria type 1 - acute encephalopathic crises - newborn screening program - dystonia

Ethics Committee Approval

The study was approved by the Ethics in Research Committee of Çukurova University Faculty of Medicine, Adana, Turkey (approval number: 2019/85–58).

Informed Consent

Consent form was filled out by all participants.

Authors' Contributions

N.Ö.-M., S.K., and B.Ş.Y. contributed toward surgical and medical practices, S.K., N.Ö.-M., and D.B. developed the concept. S.K. and D.K. designed the study. N.Ö.-M., S.K., F.İ., N.Ö., and B.O. contributed toward data collection and processing. N.Ö.-M., S.K., and G.C. did the data analysis and interpretation. D.B., S.K., and D.K. searched the literature and S.K. did the writing. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Financial Disclosure

The authors declare that this study received no financial support.

Employment or Leadership

None declared.

Honorarium

None declared.

Publication History

Received: 23 May 2020

Accepted: 28 September 2020

Article published online:
12 February 2021

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