Pilot study of classic galactosemia: Neurodevelopmental impact and other complications urge neonatal screening in Egypt

Classic galactosemia is caused by deficiency of galactose-1-phosphate uridylyltransferase (GALT). It causes serious morbidity and mortality if left untreated. Screening for galactosemia is not included in Egyptian neonatal screening program. The study aimed to define clinical presentation and compli...

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Main Authors: Magd A. Kotb, Lobna Mansour, Christine William Shaker Basanti, Wael El Garf, Ghada I.Z. Ali, Sally T. Mostafa El Sorogy, Inas E.M. Kamel, Naglaa M Kamal
Format: Article
Language:English
Published: Elsevier 2018-07-01
Series:Journal of Advanced Research
Online Access:http://www.sciencedirect.com/science/article/pii/S2090123218300213
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spelling doaj-54ed766f74b343e1aaaff8d98f8c036a2020-11-25T00:29:51ZengElsevierJournal of Advanced Research2090-12322018-07-01123945Pilot study of classic galactosemia: Neurodevelopmental impact and other complications urge neonatal screening in EgyptMagd A. Kotb0Lobna Mansour1Christine William Shaker Basanti2Wael El Garf3Ghada I.Z. Ali4Sally T. Mostafa El Sorogy5Inas E.M. Kamel6Naglaa M Kamal7Department of Pediatrics, Pediatric Hepatology Unit, Faculty of Medicine, Cairo University, Egypt; Corresponding author.Department of Pediatrics, Pediatric Neurology Unit, Faculty of Medicine, Cairo University, EgyptDepartment of Pediatrics, Pediatric Pulmonology Unit, Faculty of Medicine, Cairo University, EgyptPediatric Medicine Department, National Research Center, Cairo, EgyptDepartment of Pediatrics, Maady Military Hospital, Cairo, EgyptDepartment of Pediatrics, Public Mounira Hospital, Cairo, EgyptPediatric Medicine Department, National Research Center, Cairo, EgyptDepartment of Pediatrics, Pediatric Hepatology Unit, Faculty of Medicine, Cairo University, EgyptClassic galactosemia is caused by deficiency of galactose-1-phosphate uridylyltransferase (GALT). It causes serious morbidity and mortality if left untreated. Screening for galactosemia is not included in Egyptian neonatal screening program. The study aimed to define clinical presentation and complications of galactosemia at Pediatric Hepatology Clinic, Cairo University, Egypt. Thus, the clinical presentation, course and outcome of 37 children with documented galactosemia was studied. Jaundice was the main presentation (67.6%). Other presentations included; convulsions (29.7%), motor retardation (24.3%), mental retardation (5.4%), microcephaly (5.4%), failure to thrive (16.2%), hepatomegaly (62.2%), splenomegaly (35.1%), vomiting (16.2%), diarrhea (8.1%), liver cell failure (10.8%), renal tubular acidosis (5.4%), cataract (5.4%), autoimmune hepatitis (2.7%), self-mutilation (2.7%), combined immune deficiency (2.7%) and kernicterus (2.7%). There was no correlation of residual enzyme activity to severity, clinical presentation, liver function tests, liver biopsy findings or outcome apart from highly significant correlation with repeated chest infections (P = 0.001). Duration to diagnosis and exposure to galactose in diet correlated with liver pathology severity i.e. hepatocyte necrosis (P = 0.003) and cytoskeleton damage (P = 0.003), but not to outcome. Galactosemia should be suspected in any child with liver, neurologic disease and/or immunodeficiency. Its complications are potentially preventable. Early detection is mandatory to prevent serious morbidity and mortality. Initiation of neonatal screening for galactosemia in Egypt is recommended. Keywords: Classic galactosemia, Galactose-1-phosphate uridylyltransferase GALT, Convulsions motor retardation mental retardation, Kernicterus microcephaly, Liver cell failure autoimmune hepatitis, Cataract self-mutilation combined immune deficiencyhttp://www.sciencedirect.com/science/article/pii/S2090123218300213
collection DOAJ
language English
format Article
sources DOAJ
author Magd A. Kotb
Lobna Mansour
Christine William Shaker Basanti
Wael El Garf
Ghada I.Z. Ali
Sally T. Mostafa El Sorogy
Inas E.M. Kamel
Naglaa M Kamal
spellingShingle Magd A. Kotb
Lobna Mansour
Christine William Shaker Basanti
Wael El Garf
Ghada I.Z. Ali
Sally T. Mostafa El Sorogy
Inas E.M. Kamel
Naglaa M Kamal
Pilot study of classic galactosemia: Neurodevelopmental impact and other complications urge neonatal screening in Egypt
Journal of Advanced Research
author_facet Magd A. Kotb
Lobna Mansour
Christine William Shaker Basanti
Wael El Garf
Ghada I.Z. Ali
Sally T. Mostafa El Sorogy
Inas E.M. Kamel
Naglaa M Kamal
author_sort Magd A. Kotb
title Pilot study of classic galactosemia: Neurodevelopmental impact and other complications urge neonatal screening in Egypt
title_short Pilot study of classic galactosemia: Neurodevelopmental impact and other complications urge neonatal screening in Egypt
title_full Pilot study of classic galactosemia: Neurodevelopmental impact and other complications urge neonatal screening in Egypt
title_fullStr Pilot study of classic galactosemia: Neurodevelopmental impact and other complications urge neonatal screening in Egypt
title_full_unstemmed Pilot study of classic galactosemia: Neurodevelopmental impact and other complications urge neonatal screening in Egypt
title_sort pilot study of classic galactosemia: neurodevelopmental impact and other complications urge neonatal screening in egypt
publisher Elsevier
series Journal of Advanced Research
issn 2090-1232
publishDate 2018-07-01
description Classic galactosemia is caused by deficiency of galactose-1-phosphate uridylyltransferase (GALT). It causes serious morbidity and mortality if left untreated. Screening for galactosemia is not included in Egyptian neonatal screening program. The study aimed to define clinical presentation and complications of galactosemia at Pediatric Hepatology Clinic, Cairo University, Egypt. Thus, the clinical presentation, course and outcome of 37 children with documented galactosemia was studied. Jaundice was the main presentation (67.6%). Other presentations included; convulsions (29.7%), motor retardation (24.3%), mental retardation (5.4%), microcephaly (5.4%), failure to thrive (16.2%), hepatomegaly (62.2%), splenomegaly (35.1%), vomiting (16.2%), diarrhea (8.1%), liver cell failure (10.8%), renal tubular acidosis (5.4%), cataract (5.4%), autoimmune hepatitis (2.7%), self-mutilation (2.7%), combined immune deficiency (2.7%) and kernicterus (2.7%). There was no correlation of residual enzyme activity to severity, clinical presentation, liver function tests, liver biopsy findings or outcome apart from highly significant correlation with repeated chest infections (P = 0.001). Duration to diagnosis and exposure to galactose in diet correlated with liver pathology severity i.e. hepatocyte necrosis (P = 0.003) and cytoskeleton damage (P = 0.003), but not to outcome. Galactosemia should be suspected in any child with liver, neurologic disease and/or immunodeficiency. Its complications are potentially preventable. Early detection is mandatory to prevent serious morbidity and mortality. Initiation of neonatal screening for galactosemia in Egypt is recommended. Keywords: Classic galactosemia, Galactose-1-phosphate uridylyltransferase GALT, Convulsions motor retardation mental retardation, Kernicterus microcephaly, Liver cell failure autoimmune hepatitis, Cataract self-mutilation combined immune deficiency
url http://www.sciencedirect.com/science/article/pii/S2090123218300213
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