The landscape of pediatric genetic white matter disorders at a tertiary referral hospital in Upper Egypt and the report of 31 novel variants.

IF 3.2 3区 医学 Q1 PEDIATRICS
Mahmoud M Noureldeen, Maha S Zaki, Karima Rafat, Mohamed S Abdel-Hamid, Aida M S Salem
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引用次数: 0

Abstract

Background: Leukodystrophies (LDs) and genetic leukoencephalopathies (GLEs) encompass the spectrum of genetic white matter disorders (GWMDs). Despite their clinical significance, limited studies have investigated GWMDs in Egypt. Therefore, this study aimed to characterize pediatric patients diagnosed with GWMDs in the Beni-Suef Governorate, Upper Egypt.

Methods: We reviewed the records of patients diagnosed with GWMDs who presented over five years to the pediatric neurology clinic of a tertiary care hospital in Beni-Suef Governorate, Upper Egypt. The study included 142 patients aged < 18 years diagnosed with GWMD confirmed by brain imaging, metabolic, and/or molecular genetic testing. Patients were classified as LDs or GLEs per the 2015 Global Leukodystrophy Initiative Consortium (GLIA) criteria.

Results: Fifty-six cases were identified to have LDs, while 86 were classified as GLEs. Metachromatic leukodystrophy (MLD) was the most common LD (13 patients), followed by megalencephalic leukoencephalopathy with subcortical cysts (MLC) (10 patients). The most common GLEs were lysosomal storage disorders (LSDs) (22 patients,) followed by Cockayne syndrome (11 patients), along with other miscellaneous disorders. The cumulative incidence of GWMDs in children under 18 was estimated at 10.8 cases per 100,000 population during the five-year study period. Thirty-one novel variants were identified, comprising 10 for LDs and 21 for GLEs. The mortality rate was 39.3% and 22.1% among patients with LDs and GLEs, respectively.

Conclusions: This study presents the first cohort of GWMDs reported from the Beni-Suef Governorate, Upper Egypt. The study provides significant data regarding regional etiological patterns, clinical trajectories, and molecular profiles. Additionally, the study findings provide a foundational framework for establishing a national GWMD registry and inform future diagnostic and therapeutic strategies.

在上埃及三级转诊医院儿科遗传性白质疾病的景观和31个新变体的报告。
背景:白质营养不良症(ld)和遗传性白质脑病(GLEs)包括遗传性白质疾病(GWMDs)。尽管它们具有临床意义,但在埃及调查gwmd的研究有限。因此,本研究旨在对上埃及Beni-Suef省诊断为gwmd的儿科患者进行特征分析。方法:我们回顾了上埃及Beni-Suef省一家三级医院儿科神经病学门诊5年以上确诊为gwmd的患者的记录。研究纳入142例老年患者。结果:56例为ldds, 86例为GLEs。异色性脑白质营养不良(MLD)是最常见的LD(13例),其次是伴有皮质下囊肿的巨脑白质脑病(MLC)(10例)。最常见的GLEs是溶酶体贮积症(LSDs)(22例),其次是柯凯因综合征(11例),以及其他杂项疾病。在为期五年的研究期间,18岁以下儿童的gwmd累积发病率估计为每10万人10.8例。鉴定出31个新的变异,其中10个为ld变异,21个为GLEs变异。LDs和GLEs患者的死亡率分别为39.3%和22.1%。结论:本研究报道了上埃及贝尼-苏韦夫省报道的首个gwmd队列。该研究提供了关于区域病因模式、临床轨迹和分子谱的重要数据。此外,研究结果为建立国家GWMD登记提供了基础框架,并为未来的诊断和治疗策略提供了信息。
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来源期刊
CiteScore
6.10
自引率
13.90%
发文量
192
审稿时长
6-12 weeks
期刊介绍: Italian Journal of Pediatrics is an open access peer-reviewed journal that includes all aspects of pediatric medicine. The journal also covers health service and public health research that addresses primary care issues. The journal provides a high-quality forum for pediatricians and other healthcare professionals to report and discuss up-to-the-minute research and expert reviews in the field of pediatric medicine. The journal will continue to develop the range of articles published to enable this invaluable resource to stay at the forefront of the field. Italian Journal of Pediatrics, which commenced in 1975 as Rivista Italiana di Pediatria, provides a high-quality forum for pediatricians and other healthcare professionals to report and discuss up-to-the-minute research and expert reviews in the field of pediatric medicine. The journal will continue to develop the range of articles published to enable this invaluable resource to stay at the forefront of the field.
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