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Developmental Outcomes of School-Age Children with Duarte Galactosemia: A Pilot Study

机译:Duarte半乳糖血症学龄儿童的发展结局:一项初步研究

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摘要

Duarte galactosemia (DG) is a mild allelic variant of classic galactosemia that results from partial impairment of galactose-1P uridylyltransferase (GALT). Although infants with DG are detected by newborn screening in some US states at close to 1/4,000 live births, most are discharged from follow-up very early in life and there is no consensus on whether these children are at increased risk for any of the long-term developmental delays seen in classic galactosemia. There is also no consensus on whether infants with DG benefit from dietary restriction of galactose. Reflecting the current uncertainty, some states choose to identify infants with DG by newborn screening and others do not. As a first step toward characterizing the developmental outcomes of school-age children with DG, we conducted a pilot study, testing 10 children with DG and 5 unaffected siblings from the same group of families. All children tested were between 6 and 11 years old. We used standardized direct assessments and parent-response surveys to collect information regarding cognition, communication, socio-emotional, adaptive behavior, and physical development for each child. Despite the small sample size, our data demonstrated some notable differences between cases and controls in socio-emotional development, in delayed recall, and in auditory processing speed. These results confirm that direct assessment of school-age children with DG can detect subtle but potentially problematic developmental deficits, and underscore the need for a larger study which has sufficient power to evaluate these outcomes while controlling for potentially confounding factors.
机译:Duarte半乳糖血症(DG)是经典半乳糖血症的轻度等位基因变体,其由半乳糖1P尿酸转移酶(GALT)的部分损伤引起。尽管在美国一些州,通过新生儿筛查发现了DG婴儿,活产接近1 / 4,000,但大多数婴儿在生命的早期就被排除在外,对于这些儿童是否有更高的患病风险尚无共识。经典半乳糖血症所见的长期发育迟缓。对于DG患儿是否从半乳糖饮食限制中获益尚无共识。反映当前的不确定性,一些州选择通过新生儿筛查来识别患有DG的婴儿,而其他州则没有。作为表征学龄儿童DG发育结果的第一步,我们进行了一项先导研究,测试了来自同一家庭的10名DG儿童和5名未受影响的兄弟姐妹。所有接受测试的儿童均为6至11岁。我们使用标准化的直接评估和父母回应调查来收集有关每个孩子的认知,沟通,社会情感,适应行为和身体发育的信息。尽管样本量很小,但我们的数据表明,案例与对照之间在社会情感发展,回想延迟和听觉处理速度方面存在显着差异。这些结果证实,对学龄儿童DG的直接评估可以发现细微但可能存在问题的发育缺陷,并强调需要进行更大的研究,该研究应有足够的能力评估这些结果,同时控制潜在的混杂因素。

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