An unexpectedly high frequency of hypergalactosemia in an immigrant Bosnian population revealed by newborn screening.
In galactokinase (GALK) deficiency, galactose cannot be phosphorylated into galactose-1-phosphate, which leads to cataract formation. Neonatal screening for hypergalactosemia in Berlin has been performed by thin-layer chromatography since 1978, which detects classical galactosemia and GALK deficiency. Until 1991, GALK deficiency has not been identified in a total of approximately 260,000 samples. In contrast, from 1992 to 1999, nine patients were detected in a total of approximately 240,000 screened newborns. One Turkish patient was homozygous for two novel S142I/G148C GALK mutations in close proximity to the putative ATP-binding site of the enzyme. The other eight children were born to five families belonging to the Bosnian refugee population consisting of approximately 30,000 individuals who have arrived in Berlin since 1991. In two of these families, GALK deficiency was subsequently diagnosed in siblings who had cataract surgery at 4 and 5 y of age, respectively. In all these 10 Bosnian patients, a homozygous P28T mutation located near the active center of the enzyme was identified. We propose that neonatal screening of populations with a significant proportion of Bosnians and possibly other southeastern Europeans, e.g. Romani, should be particularly directed toward GALK deficiency, an inborn error of metabolism that is readily amenable to effective treatment.
Reich
Susanne
S
Children's Hospital, Charité, Campus Virchow, Humboldt University, D-10247 Berlin, Germany.
Hennermann
Julia
J
Vetter
Barbara
B
Neumann
Luitgard M
LM
Shin
Yoon S
YS
Söling
Ariane
A
Mönch
Eberhard
E
Kulozik
Andreas E
AE
D000255:Adenosine Triphosphate / Q000378:metabolism; D000595:Amino Acid Sequence; D019943:Amino Acid Substitution; D001604:Berlin / Q000453:epidemiology; D001665:Binding Sites; D017522:Bosnia and Herzegovina / Q000208:ethnology; D002386:Cataract / Q000209:etiology; D002675:Child, Preschool; D005260:Female; D005686:Galactokinase / Q000737:chemistry / Q000172:deficiency* / Q000235:genetics; D005693:Galactosemias / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology / Q000235:genetics; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D008969:Molecular Sequence Data; D020125:Mutation, Missense; D015997:Neonatal Screening; D017354:Point Mutation; D014421:Turkey / Q000208:ethnology
D000255:Adenosine Triphosphate; D005686:Galactokinase