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Yonsei Med J. 2018 Jul;59(5):652-661. doi: 10.3349/ymj.2018.59.5.652.

A New Integrated Newborn Screening Workflow Can Provide a Shortcut to Differential Diagnosis and Confirmation of Inherited Metabolic Diseases.

Author information

1
Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
2
SD Genomics Co., Ltd., Seoul, Korea.
3
Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
4
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
5
Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea. KAL1119@yuhs.ac.
6
Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kimjw@skku.edu.

Abstract

PURPOSE:

We developed a new workflow design which included results from both biochemical and targeted gene sequencing analysis interpreted comprehensively. We then conducted a pilot study to evaluate the benefit of this new approach in newborn screening (NBS) and demonstrated the efficiency of this workflow in detecting causative genetic variants.

MATERIALS AND METHODS:

Ten patients in Group 1 were diagnosed clinically using biochemical assays only, and 10 newborns in Group 2 were diagnosed with suspected inherited metabolic disease (IMD) in NBS. We applied NewbornDiscovery (SD Genomics), an integrated workflow design that encompasses analyte-phenotype-gene, single nucleotide variant/small insertion and deletion/copy number variation analyses along with clinical interpretation of genetic variants related to each participant's condition.

RESULTS:

A molecular genetic diagnosis was established in 95% (19/20) of individuals. In Group 1, 13 and 7 of 20 alleles were classified as pathogenic and likely pathogenic, respectively. In Group 2, 11 and 6 of 17 alleles with identified causative variants were pathogenic and likely pathogenic, respectively. There were no variants of uncertain significance. For each individual, the NewbornDiscovery and biochemical analysis results reached 100% concordance, since the single newborn testing negative for causative genetic variant in Group 2 showed a benign clinical course.

CONCLUSION:

This integrated diagnostic workflow resulted in a high yield. This approach not only enabled early confirmation of specific IMD, but also detected conditions not included in the current NBS.

KEYWORDS:

Newborn screening; dried blood spot; inherited metabolic disease; next-generation sequencing; targeted gene panel sequencing

PMID:
29869463
PMCID:
PMC5990675
DOI:
10.3349/ymj.2018.59.5.652
[Indexed for MEDLINE]
Free PMC Article

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