Journal of Clinical Pediatrics ›› 2019, Vol. 37 ›› Issue (12): 889-.doi: 10.3969/j.issn.1000-3606.2019.12.003

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Clinical analysis of methionine adenosyltransferase Ⅰ / Ⅲ deficiency in 5 confirmed cases in neonatal screening

ZHANG Zhilei, SUN Yun, Wang Yanyun, MA Dingyuan, CHENG Wei, JIANG Tao   

  1. Center of Genetic Medicine, The Affiliated Obstetrics and Gynecology Hospital with Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, Jiangsu, China
  • Published:2020-02-03

Abstract: Objective To explore the clinical and gene variation characteristics of methionine adenosyltransferase Ⅰ/Ⅲ deficiency. Methods The clinical data and gene detection of methionine adenosyltransferase Ⅰ/Ⅲ deficiency in 5 newborns found by tandem mass spectrometry in neonatal screening were retrospectively analyzed. Results In the 220000 newborns screened, 5 cases of methionine adenosyltransferase Ⅰ/Ⅲ deficiency were found and an incidence rate was 1/44000. In the 5 newborns, the concentrations of methionine were 70~150 μmol/L in 3 newborns, among whom 2 were autosomal dominant inheritance and one was autosomal recessive inheritance and all of them had a good prognosis. The blood methionine concentrations of the other 2 newborns were continuously greater than 500 μmol/L and they were autosomal recessive inheritance. These 2 newborns were treated with special diet. During follow-up, 1 patient had abnormal cranial magnetic resonance and abnormal liver function, and 1 patient had microdeletion syndrome and developmental retardation. Conclusion Methionine adenosyltransferase Ⅰ/Ⅲ deficiency can be diagnosed early by tandem mass spectrometry combined with gene detection and the disease requires long-term follow-up.

Key words:  tandem mass spectrometry; methionine adenosyltransferase Ⅰ/Ⅲ deficiency; MAT1A gene; follow-up