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Retrospective study of the medium‐chain acyl‐CoA dehydrogenase deficiency in Portugal
Authors:A. Luz  I.A. Rivera  M.F.B. Silva  R. Ramos  H. Rocha  A. Lopes  H. Fonseca  A. Gaspar  L. Diogo  E. Martins  E. Leão‐Teles  L. Vilarinho  I. Tavares de Almeida
Affiliation:1. Metabolism and Genetics Group, Research Institute for Medicines and Pharmaceutical Sciences, iMed.UL, Faculty of Pharmacy;2. Department of Biochemistry and Human Biology, Faculty of Pharmacy, University of Lisbon, , Lisbon, Portugal;3. Newborn Screening, Metabolism and Genetics Unit, Genetics Department, National Institute of Health Dr. Ricardo Jorge, , Porto, Portugal;4. Department of Pediatrics, Lisbon North Hospital Center, Santa Maria Hospital, , Lisbon, Portugal;5. Children's Hospital of Coimbra, Metabolic Disorders Unit, , Coimbra, Portugal;6. Children's Hospital Maria Pia, Metabolic Diseases Unit, , Porto, Portugal;7. S. Jo?o Hospital Center, Metabolic Diseases Pediatric Unit, , Porto, Portugal
Abstract:Medium‐chain acyl‐CoA dehydrogenase deficiency (MCADD) is the commonest genetic defect of mitochondrial fatty acid β‐oxidation. About 60% of MCADD patients are homozygous for the c.985A>G (p.Lys329Glu) mutation in the ACADM gene (G985 allele). Herein, we present the first report on the molecular and biochemical spectrum of Portuguese MCADD population. From the 109 patients studied, 83 were diagnosed after inclusion of MCADD in the national newborn screening, 8 following the onset of symptoms and 18 through segregation studies. Gypsy ancestry was identified in 85/109 patients. The G985 allele was found in homozygosity in 102/109 patients, in compound heterozygosity in 6/109 and was absent in one patient. Segregation studies in the Gypsy families showed that 93/123 relatives were carriers of the G985 allele, suggesting its high prevalence in this ethnic group. Additionally, three new substitutions—c.218A>G (p.Tyr73Cys), c.503A>T (p.Asp168Val) and c.1205G>T (p.Gly402Val)—were identified. Despite the particularity of the MCADD population investigated, the G985 allele was found in linkage disequilibrium with H1(112) haplotype. Furthermore, two novel haplotypes, H5(212) and H6(122) were revealed.
Keywords:ACADM  inborn errors of metabolism  MCAD  mitochondrial fatty acid β  ‐oxidation disorders  newborn screening
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