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ABSTRACT: Introduction
Citrullinemia Type 1 (CTLN1) is an autosomal recessive disorder caused by variants in the ASS1 gene. This study intends to clarify the etiology of false positives in newborn screening for citrullinemia.Method
Newborns who had elevated dried-blood spot citrulline levels were enrolled, and medical records were reviewed retrospectively. Common ASS1 variants were screened using high-resolution melting analysis.Result
Between 2011 and 2021, 130 newborns received confirmatory testing for citrullinemia, 4 were found to be patients for CTLN1; 11 were patients with citrin deficiency; and 49 newborns were confirmed to be carrying one pathogenic ASS1 variant. The incidence of CTLN1 was 1 in 188,380 (95% confidence interval: 1 in 73,258 to 1 in 484,416). All ASS1 variants studied in this cohort were located in exons 11 to 15, which encode the tetrameric interface regions of the ASS1 protein. Among 10 ASS1 carriers with elevated citrulline levels and complete sequence data, four (40%) revealed additional non-benign ASS1 variants; in contrast, only 2 of the 26 controls (7.7%), with normal citrulline levels, had additional ASS1 variants.Conclusion
Heterozygote ASS1 variants may lead to a mild elevation of blood citrulline levels: about 2-6 times the population mean. Molecular testing and family studies remain critical for precise diagnosis, genetic counseling, and management.
SUBMITTER: Chen HA
PROVIDER: S-EPMC9482393 | biostudies-literature | 2022 Sep
REPOSITORIES: biostudies-literature
Chen Hui-An HA Hsu Rai-Hseng RH Chang Kai-Ling KL Huang Yi-Chen YC Chiang Yun-Chen YC Lee Ni-Chung NC Hwu Wuh-Liang WL Chiu Pao-Chin PC Chien Yin-Hsiu YH
Molecular genetics & genomic medicine 20220621 9
<h4>Introduction</h4>Citrullinemia Type 1 (CTLN1) is an autosomal recessive disorder caused by variants in the ASS1 gene. This study intends to clarify the etiology of false positives in newborn screening for citrullinemia.<h4>Method</h4>Newborns who had elevated dried-blood spot citrulline levels were enrolled, and medical records were reviewed retrospectively. Common ASS1 variants were screened using high-resolution melting analysis.<h4>Result</h4>Between 2011 and 2021, 130 newborns received c ...[more]