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Lysosomal Storage Disorders in Egyptian Children
Mohamed A Elmonem1,2,3, Iman G Mahmoud4,5, Dina A Mehaney6,4
1Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt. mohamed.abdelmonem@kasralainy.edu.eg.
Insights
This study details lysosomal storage disorders in Egyptian children, finding mucopolysaccharidoses most common. Many patients lack optimal diagnosis, highlighting the need for improved genetic services in Egypt.
Area of Science:
- Medical Genetics
- Pediatric Metabolism
- Rare Diseases
Background:
- Lysosomal storage disorders (LSDs) are a group of rare genetic conditions.
- Accurate diagnosis and characterization of LSDs are crucial for patient management.
- Limited data exists on the spectrum and prevalence of LSDs in Egypt.
Purpose of the Study:
- To characterize the spectrum, relative frequency, and molecular basis of LSDs in Egyptian children.
- To evaluate a selective screening program for LSD diagnosis.
- To identify gaps in diagnostic and genetic services for LSDs in Egypt.
Main Methods:
- A six-year retrospective evaluation (2008-2014) of 1,065 suspected children at Cairo University Children's Hospital.
- Clinical, biochemical, and genetic assessments were performed.
- Analysis of diagnosed LSDs, including specific types and detected mutations.
Main Results:
- 211 children were diagnosed with 21 different LSDs.
- Mucopolysaccharidoses (44.5%) were the most common group; Maroteaux-Lamy (17.1%), Gaucher (14.7%), and nephropathic cystinosis (13.7%) were most frequent.
- 80 mutant alleles and 17 mutations were identified in 48 genetically assessed patients.
Conclusions:
- This is the first report on the relative frequency and molecular data of LSDs in a large Egyptian cohort.
- Over 80% of Egyptian LSD patients may lack access to optimal diagnosis.
- Enhancing diagnostic and genetic services for LSDs in Egypt is essential.
Objective:
To describe the spectrum, relative prevalence and molecular background of lysosomal storage disorders in Egypt.
Methods:
The authors evaluated the selective screening program for the diagnosis of lysosomal storage disorders in Egyptian children presenting to the inherited metabolic disease unit at Cairo University Children's Hospital, the largest tertiary care pediatric hospital in Egypt, over a six-year period (April 2008 through April 2014). During this period, 1,065 suspected children were assessed clinically, biochemically and some genetically.
Results:
Two hundred and eleven children (aged 44 ± 32 mo; 56 % boys, 82 % with consanguineous parents) were confirmed with 21 different lysosomal disorders. The diagnostic gap ranged between 2 mo and 14 y (average 25 mo). Mucopolysaccharidoses were the most common group of diseases diagnosed (44.5 %), while Maroteaux-Lamy, Gaucher and nephropathic cystinosis were the most commonly detected syndromes (17.1, 14.7 and 13.7 %, respectively). Eighty mutant alleles and 17 pathogenic mutations were detected in 48 genetically assessed confirmed patients (30 Gaucher, 16 cystinosis and two Niemann-Pick type C patients).
Conclusions:
This report is the first to describe relative frequency and spectrum of clinical and molecular data in a large cohort of Egyptian lysosomal patients. The crude estimate denotes that over 80 % of Egyptian lysosomal patients do not have access to optimal diagnosis. Upgrading diagnostic and genetic services for lysosomal storage disorders in Egypt is absolutely necessary.
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