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Ricci D, Martinelli D, Ferrantini G, Lucibello S, Gambardella ML, Olivieri G, Chieffo D, Battaglia D, Diodato D, Iarossi G, Donati AM, Dionisi-Vici C, Battini R, Mercuri EM. Early neurodevelopmental characterization in children with cobalamin C/defect. J Inherit Metab Dis 2020; 43:367-374. [PMID: 31503356 DOI: 10.1002/jimd.12171] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 09/03/2019] [Accepted: 09/09/2019] [Indexed: 02/03/2023]
Abstract
Cobalamin C (cblC) defect is the most common inherited disorder of cobalamin metabolism. Developmental delay, behavioral problems, and maculopathy are common, but they have not been systematically investigated. The aim of this study was to define early neurodevelopment in cblC patients and the possible contribution of different factors, such as mode of diagnosis, age at diagnosis, presence of brain lesions and epilepsy. Children up to the age of 4 years with a visual acuity ≥1/10 were evaluated using the Griffiths' Mental Development Scales. Eighteen children were enrolled (age range 12-48 months). Four were diagnosed by newborn screening (NBS); in the others mean age at diagnosis was 3.5 months (range 0.3-18 months). Eight had seizures: three in the first year, and five after the second year of life. Fourteen had brain lesions on magnetic resonance imaging (MRI). Neurovisual assessment evidenced low visual acuity (<3/10) in 4/18. NBS diagnosed patients had higher general and subquotients neurodevelopmental scores, normal brain MRI, and no epilepsy. The others showed a progressive reduction of the developmental quotient with age and language impairment, which was evident after 24 months of age. Our findings showed a progressive neurodevelopmental deterioration and a specific fall in language development after 24 months in cblC defect. The presence of brain lesions and epilepsy was associated with a worst neurodevelopmental outcome. NBS, avoiding major disease-related events and allowing an earlier treatment initiation, appeared to have a protective effect on the development of brain lesions and to promote a more favorable neurodevelopment.
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Affiliation(s)
- Daniela Ricci
- Pediatric Neurology, Department of Human and Child Health and Public Health, Child Health Area, Catholic University UCSC, Rome, Italy
- National Centre of Services and Research for the Prevention of Blindness and Visual Rehabilitation of Visually Impaired, Rome, Italy
| | - Diego Martinelli
- Division of Metabolism, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Gloria Ferrantini
- Pediatric Neurology, Department of Human and Child Health and Public Health, Child Health Area, Catholic University UCSC, Rome, Italy
| | - Simona Lucibello
- Pediatric Neurology, Department of Human and Child Health and Public Health, Child Health Area, Catholic University UCSC, Rome, Italy
| | - MLuigia Gambardella
- Pediatric Neurology, Department of Human and Child Health and Public Health, Child Health Area, Catholic University UCSC, Rome, Italy
| | - Giorgia Olivieri
- Pediatric Neurology, Department of Human and Child Health and Public Health, Child Health Area, Catholic University UCSC, Rome, Italy
- Division of Metabolism, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Daniela Chieffo
- Pediatric Neurology, Department of Human and Child Health and Public Health, Child Health Area, Catholic University UCSC, Rome, Italy
| | - Domenica Battaglia
- Pediatric Neurology, Department of Human and Child Health and Public Health, Child Health Area, Catholic University UCSC, Rome, Italy
| | - Daria Diodato
- Division of Metabolism, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Giancarlo Iarossi
- Division of Metabolism, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Alice M Donati
- Unit of Metabolic and Muscular Diseases, A. Meyer Children Hospital, Florence, Italy
| | - Carlo Dionisi-Vici
- Division of Metabolism, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Roberta Battini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Eugenio M Mercuri
- Pediatric Neurology, Department of Human and Child Health and Public Health, Child Health Area, Catholic University UCSC, Rome, Italy
- Nemo Clinical Centre, Policlinico Gemelli Foundation, IRCCS, Rome, Italy
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Mure T, Nakagawa T, Okizuka Y, Takami Y, Oyazato Y, Nagase H, Maruyama A, Adachi M, Takada S, Matsuo M. Treatment of preterm infants with West syndrome: differences due to etiology. Pediatr Int 2012; 54:892-8. [PMID: 22882769 DOI: 10.1111/j.1442-200x.2012.03708.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Revised: 05/28/2012] [Accepted: 08/02/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study was conducted with a particular focus on preterm infants with West syndrome (WS) to evaluate differences in the first responses to oral medication based on etiology. METHODS Medical records of 53 patients with WS, treated at five institutions between 2005 and 2009, were reviewed retrospectively. Patients were divided into six groups based on the time of brain insult, and evaluated for short-term outcomes using oral anti-epileptic agents and synthetic adrenocorticotropic hormone. RESULTS The sample consisted of 15, six, 14, two, four, and 12 patients classified, on the basis of apparent time of acquisition of etiology, into the prenatal, term, preterm, postnatal, other, and no identified etiology groups, respectively. Average age of onset in the term group was 3.3 ± 1.0 months, significantly earlier than in the prenatal, preterm, postnatal and no identified etiology groups (P < 0.05). All patients in the term group had experienced seizures before the onset of WS. Only patients in the preterm group had only experienced neonatal seizures, and responded better to treatment. Patients in the preterm group had better responses to treatment, especially oral medication, compared with those in the prenatal and term groups. The prevalence of relapse of seizures in the preterm group (14%) was significantly lower than that in the prenatal group. CONCLUSIONS Preterm WS patients responded well to treatment. Distinguishing WS patients on the basis of different etiologies is important for evaluating the effectiveness of treatment.
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Affiliation(s)
- Takeo Mure
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
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