title: Normal Levels of Plasma Free Carnitine and Acylcarnitines in Follow-Up Samples from a Presymptomatic Case of Carnitine Palmitoyl Transferase 1 (CPT1) Deficiency Detected Through Newborn Screening in Denmark.
abstract: Carnitine palmitoyl transferase (CPT) 1 A deficiency is a rare disorder of hepatic long-chain fatty acid oxidation. CPT1 deficiency is included in newborn screening programs in a number of countries to allow presymptomatic detection and early treatment of affected patients.We present a case of presymptomatic CPT1A deficiency detected through newborn screening in Denmark with diagnostic levels of carnitine and acylcarnitines in the initial dried blood spot. Levels of plasma-free carnitine and acylcarnitines in follow-up samples were normal, but reverted to diagnostic levels when the patient developed clinical symptoms at the age of 8 months. At that time, a diagnosis of CPT1A deficiency was confirmed by sequence analysis of the CPT1A gene revealing homozygosity for a novel c.167C>T variation in exon 3. Enzyme activity measurements showed a relatively mild enzyme defect with a decreased residual enzyme activity of 17-25%. We conclude that CPT1A gene testing and/or enzyme assay is mandatory to confirm an abnormal newborn screen suggesting CPT1A deficiency to avoid delayed diagnoses.
authors: Paediatric Department, Aarhus University Hospital Skejby, Aarhus, Denmark, lborch@live.dk.
authors: Luise
authors: L
authors: Borch
authors: Allan Meldgaard
authors: AM
authors: Lund
authors: Flemming
authors: F
authors: Wibrand
authors: Ernst
authors: E
authors: Christensen
authors: Charlotte
authors: C
authors: Søndergaard
authors: Birthe
authors: B
authors: Gahrn
authors: David Michael
authors: DM
authors: Hougaard
authors: Brage Storstein
authors: BS
authors: Andresen
authors: Niels
authors: N
authors: Gregersen
authors: Rikke Katrine Jentoft
authors: RK
authors: Olsen