Neonatal Medicine

Screening

Newborn Blood spot Screening

Image by U.S. Air Force photo/Staff Sgt Eric T. Sheler - USAF Photographic Archives, Public Domain


Blood spot screening takes place between days 5-7 for all infants. As of January 2015 9 conditions are tested for:


> Phenylketonuria (PKU)                        > Congenital Hypothyroidism                  > Sickle Cell Disease

 - Unable to metabolise                               - Affects 1 in 3000 babies                           - Affects 1 in 2000 babies

 phenylalanine                                             - Not usually inherited                                  - Well at birth due to HbF

 - Untreated leads to LD,                             - If untreated leads to mental                       - Affected children require

 behavioural problems                                 retardation                                                    Pen V prophylaxis and f/u

 - Dietary management                                - Thyroxine replacement                              - May detect B thalassaemia


> Medium Chain Acyl-CoA                     > Cystic Fibrosis                                      > Isovaleric Acidaemia*

Dehydrogenase Def (MCADD)                   - Affects 1 in 2500 babies                         - Autosomal recessive disorder

- Affects 1 in 10,000 babies                          - Testing is for Immunoreactive                  - Unable to metabolise leucine

- Autosomal recessive condition                     Trypsin (IRT)                                                amino acid

- Inability to metabolise type of fat                 - Multi-system disorder causing

- Can become acutely unwell when                recurrent lung infection and mal-

starved or stressed - diagnosis allows             absorption with FTT

education and planning                                  - MDT approach to management


> Maple Syrup Urine Disease                 > Homocystinuria (HCU)*                       > Glutaric Aciduria type 1(GA1) *

(MSUD)*                                                     - Autosomal recessive disorder                  - Autosomal recessive disorder

- Autosomal recessive disorder                   - Unable to metabolise homo-                     - Unable to metabolise lysine

- Unable to metabolise leucine,                   systeine amino acid                                    and tryptophan amino acids

isoleucine and valine AAs.                          - Pyridoxine unresponsive


*Condition added from January 2015


Additional information is available via the Public Health England website