Relative Frequency of Metachromatic Leukodystrophy in Egypt: A Reference Laboratory Report.

Ekram Fateen, Zeinab Y Abdallah
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Abstract

Background: Metachromatic leukodystrophy (MLD) is an autosomal recessive hereditary neurodegenerative disease caused by a deficiency in arylsulfatase A (ARSA) activity and belongs to the group of lysosomal storage diseases. A biochemical diagnosis of MLD is based on determining the residual ARSA activity in leukocytes, skin fibroblasts, and urine. This study documents our biochemical experience and estimates the relative frequency of MLD over 21 years (2001-2022).

Methods: This study analyzed 4357 suspected cases of MLD in Egypt. The ARSA activity was spectrophotometrically determined in leukocytes in all the referred cases.

Results: Of these 4357 referred cases, 577 (13%) possessed decreased ARSA activity, less than 10% of the low normal range (50-200 micromole/gram protein/hour (μmol/g protein/h), and 104 cases were diagnosed as having a pseudodeficiency in enzyme activity (<20-50% of low-normal ARSA activity). The prevalence of MLD was 1.6/100,000.

Conclusions: A diagnosis of MLD in Egypt is based on enzyme activity levels and clinical suspicion; molecular analysis was performed in a few cases.

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埃及异色性脑白质营养不良的相对频率:一份参考实验室报告。
背景:异色性脑白质营养不良症(MLD)是一种常染色体隐性遗传的神经退行性疾病,由芳基硫酸酯酶a (ARSA)活性缺乏引起,属于溶酶体贮积性疾病。MLD的生化诊断是基于测定白细胞、皮肤成纤维细胞和尿液中残留的ARSA活性。本研究记录了我们的生化经验,并估计了21年来(2001-2022年)MLD的相对频率。方法:对埃及4357例MLD疑似病例进行分析。用分光光度法测定了所有病例中白细胞的ARSA活性。结果:在4357例病例中,577例(13%)ARSA活性降低,低于正常低范围(50-200微摩尔/克蛋白/小时(μmol/g蛋白/小时)的10%,104例被诊断为酶活性假缺乏(结论:埃及MLD的诊断是基于酶活性水平和临床怀疑;对少数病例进行了分子分析。
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