Elevated Arginine Family Fact Sheet

Total Page:16

File Type:pdf, Size:1020Kb

Elevated Arginine Family Fact Sheet Family Minnesota Newborn Fact SheetPositive Result: Screening Program Blood Spot Screen Result Notification Elevated Arginine What was found on the newborn screen? What health problems can it cause? The newborn screen that was collected at birth found Argininemia is a lifelong condition. A child with that your baby has high levels of an amino acid called argininemia usually has no symptoms in the newborn arginine. period. If left untreated, it can cause: • Lack of energy What does this mean? • Poor feeding High levels of arginine can indicate that your child has • argininemia. A positive result does not mean your baby Poor growth has argininemia, but more testing is needed to know • High levels of ammonia in the blood for sure. (hyperammonemia) • Tight, rigid muscles (spasticity) What happens next? • Intellectual disabilities Your baby’s doctor or a metabolic specialist will help • Seizures arrange for more testing. Your baby will also be seen by a metabolic specialist. Children with argininemia can benefit from prompt and careful treatment. What is argininemia? What treatment options are available? Argininemia is part of a group of disorders called amino Treatment for argininemia consists of a special diet that acid disorders. Children with argininemia are unable to avoids protein. Certain medications and supplements process ammonia, a waste product that is created when may be prescribed. Early treatment can be beneficial. the body breaks down amino acids from protein. This Even with treatment, some children still have episodes causes dangerous amounts of ammonia to build up in of high ammonia. This can result in long-term the body. intellectual disabilities and spasticity. Children with argininemia should see their regular doctor and a doctor who specializes in metabolic disorders. Resources Genetics Home Reference: Save Babies Through Screening Foundation: Baby’s First Test: http://ghr.nlm.nih.gov www.savebabies.org www.babysfirsttest.org Newborn Screening Program, 601 Robert St. N., St. Paul, MN 55155 Phone (800) 664-7772, Fax (651) 215-6285 *interpreters available REV 12/2018.
Recommended publications
  • Hyperammonemia in Review: Pathophysiology, Diagnosis, and Treatment
    Pediatr Nephrol DOI 10.1007/s00467-011-1838-5 EDUCATIONAL REVIEW Hyperammonemia in review: pathophysiology, diagnosis, and treatment Ari Auron & Patrick D. Brophy Received: 23 September 2010 /Revised: 9 January 2011 /Accepted: 12 January 2011 # IPNA 2011 Abstract Ammonia is an important source of nitrogen and is the breakdown and catabolism of dietary and bodily proteins, required for amino acid synthesis. It is also necessary for respectively. In healthy individuals, amino acids that are not normal acid-base balance. When present in high concentra- needed for protein synthesis are metabolized in various tions, ammonia is toxic. Endogenous ammonia intoxication chemical pathways, with the rest of the nitrogen waste being can occur when there is impaired capacity of the body to converted to urea. Ammonia is important for normal animal excrete nitrogenous waste, as seen with congenital enzymatic acid-base balance. During exercise, ammonia is produced in deficiencies. A variety of environmental causes and medica- skeletal muscle from deamination of adenosine monophos- tions may also lead to ammonia toxicity. Hyperammonemia phate and amino acid catabolism. In the brain, the latter refers to a clinical condition associated with elevated processes plus the activity of glutamate dehydrogenase ammonia levels manifested by a variety of symptoms and mediate ammonia production. After formation of ammonium signs, including significant central nervous system (CNS) from glutamine, α-ketoglutarate, a byproduct, may be abnormalities. Appropriate and timely management requires a degraded to produce two molecules of bicarbonate, which solid understanding of the fundamental pathophysiology, are then available to buffer acids produced by dietary sources. differential diagnosis, and treatment approaches available.
    [Show full text]
  • Effect of Propionic Acid on Fatty Acid Oxidation and U Reagenesis
    Pediat. Res. 10: 683- 686 (1976) Fatty degeneration propionic acid hyperammonemia propionic acidemia liver ureagenesls Effect of Propionic Acid on Fatty Acid Oxidation and U reagenesis ALLEN M. GLASGOW(23) AND H. PET ER C HASE UniversilY of Colorado Medical Celller, B. F. SlOlillsky LaboralOries , Denver, Colorado, USA Extract phosphate-buffered salin e, harvested with a brief treatment wi th tryps in- EDTA, washed twice with ph os ph ate-buffered saline, and Propionic acid significantly inhibited "CO z production from then suspended in ph os ph ate-buffe red saline (145 m M N a, 4.15 [I-"ejpalmitate at a concentration of 10 11 M in control fibroblasts m M K, 140 m M c/, 9.36 m M PO" pH 7.4) . I n mos t cases the cells and 100 11M in methyl malonic fibroblasts. This inhibition was we re incubated in 3 ml phosph ate-bu ffered sa lin e cont aining 0.5 similar to that produced by 4-pentenoic acid. Methylmalonic acid I1Ci ll-I4Cj palm it ate (19), final concentration approximately 3 11M also inhibited ' 'C0 2 production from [V 'ejpalmitate, but only at a added in 10 II I hexane. Increasing the amount of hexane to 100 II I concentration of I mM in control cells and 5 mM in methyl malonic did not impair palmit ate ox id ation. In two experiments (Fig. 3) the cells. fibroblasts were in cub ated in 3 ml calcium-free Krebs-Ringer Propionic acid (5 mM) also inhibited ureagenesis in rat liver phosphate buffer (2) co nt ain in g 5 g/ 100 ml essent iall y fatty ac id slices when ammonia was the substrate but not with aspartate and free bovine se rum albumin (20), I mM pa lm itate, and the same citrulline as substrates.
    [Show full text]
  • CCA One Care Options Formulary
    Commonwealth Care Alliance One Care Plan (Medicare-Medicaid Plan) 2021 List of Covered Drugs (Formulary) 30 Winter Street • Boston, MA 02108 PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN For more recent information or other questions, contact Commonwealth Care Alliance Member Services at 1-866-610-2273 (TTY: call MassRelay at 711), 8 a.m. – 8 p.m., 7 days a week, or visit www.commonwealthonecare.org H0137_CF2021 Approved Formulary: ID 00021588 • Version 13 • Updated on 08/01/2021 One Care Plan | 2021 List of Covered Drugs (Formulary) Introduction This document is called the List of Covered Drugs (also known as the Drug List). It tells you which prescription drugs, over-the-counter drugs and items are covered by Commonwealth Care Alliance. The Drug List also tells you if there are any special rules or restrictions on any drugs covered by One Care. Key terms and their definitions appear in the last chapter of the Member Handbook. Table of Contents A. Disclaimers ........................................................................................................................ 4 B. Frequently Asked Questions (FAQ) .................................................................................. 5 What prescription drugs are on the List of Covered Drugs? (We call the List of Covered Drugs the “Drug List” for short.) ................................................................... 5 B2. Does the Drug List ever change? ............................................................................... 5 B3. What happens when there is a change to the Drug List? ........................................... 6 B4. Are there any restrictions or limits on drug coverage or any required actions to take to get certain drugs? .................................................................................................. 7 B5. How will you know if the drug you want has limitations or if there are required actions to take to get the drug? .................................................................................
    [Show full text]
  • Propionic Acidemia Information for Health Professionals
    Propionic Acidemia Information for Health Professionals Propionic acidemia is an organic acid disorder in which individuals are lacking or have reduced activity of the enzyme propionyl-CoA carboxylase, leading to propionic acidemia. Clinical Symptoms Symptoms generally begin in the first few days following birth. Metabolic crisis can occur, particularly after fasting, periods of illness/infection, high protein intake, or during periods of stress on the body. Symptoms of a metabolic crisis include lethargy, behavior changes, feeding problems, hypotonia, and vomiting. If untreated, metabolic crises can lead to tachypnea, brain swelling, cardiomyopathy, seizures, coma, basal ganglia stroke, and death. Many babies die within the first year of life. Lab findings during a metabolic crisis commonly include urine ketones, hyperammonemia, metabolic acidosis, low platelets, low white blood cells, and high blood ammonia and glycine levels. Long term effects may occur despite treatment and include developmental delay, brain damage, dystonia, failure to thrive, short stature, spasticity, pancreatitis, osteoporosis, and skin lesions. Incidence Propionic acidemia occurs in greater than 1 in 75,000 live births and is more common in Saudi Arabians and the Inuit population of Greenland. Genetics of propionic acidemia Mutations in the PCCA and PCCB genes cause propionic acidemia. Mutations prevent the production of or reduce the activity of propionyl-CoA carboxylase, which converts propionyl-CoA to methylmalonyl-CoA. This causes the body to be unable to correctly process isoleucine, valine, methionine, and threonine, resulting in an accumulation of glycine and propionic acid, which causes the symptoms seen in this condition. How do people inherit propionic acidemia? Propionic acidemia is inherited in an autosomal recessive manner.
    [Show full text]
  • Newborn Screening Laboratory Manual of Services
    Newborn Screening Laboratory Manual of Services Test Panel: Please see the following links for a detailed description of testing in the Newborn Screening section. Information about the Newborn Screening program is available here. Endocrine Disorders Congenital adrenal hyperplasia (CAH) Congenital hypothyroidism (TSH) Hemoglobinopathies Sickle cell disease (FS) Alpha (Barts) Sickle βeta Thalassemia (FSA) Other sickling hemoglobinopathies such as: FAS FAC FAD FAE Homozygous conditions such as: FC FD FE Metabolic Disorders Biotinidase deficiency Galactosemia Cystic fibrosis (CF) first tier screening for elevated immunoreactive trypsinogen (IRT) Cystic fibrosis second tier genetic mutation analysis on the top 4% IRT concentrations. Current alleles detected : F508del, I507del, G542X, G85E, R117H, 621+1G->T, 711+1G->T, R334W, R347P, A455E, 1717-1G->A, R560T, R553X, G551D, 1898+1G->A, 2184delA, 2789+5G->A, 3120+1G->A, R1162X, 3659delC, 3849+10kbC->T, W1282X, N1303K, IVS polyT T5/T7/T9 *Currently validating a mutation panel that includes the above alleles in addition to the following: 1078delT, Y122X, 394delTT, R347H, M1101K, S1255X, 1898+5G->T, 2183AA->G, 2307insA, Y1092X, 3876delA, 3905insT, S549N, S549R_1645A->C, S549R-1647T->G, S549R-1647T->G, V520F, A559T, 1677delTA, 2055del9->A, 2143delT, 3199del6, 406-1G->A, 935delA, D1152H, CFTRdele2, E60X, G178R, G330X, K710X, L206W, Q493X, Q890X, R1066C, R1158X, R75X, S1196X, W1089X, G1244E, G1349D, G551S, R560KT, S1251N, S1255P Amino acid disorders Phenylketonuria (PKU) / Hyperphenylalaninemia Maple
    [Show full text]
  • Disorders Included in the Newborn Screening Panel Disorders
    Disorders Included in the Newborn Screening Panel Disorders Detected by Tandem Mass Spectrometry Acylcarnitine Profile Amino Acid Profile Fatty Acid Oxidation Disorders Amino Acid Disorders Carnitine/Acylcarnitine Translocase Deficiency Argininemia 1 Carnitine Palmitoyl Transferase Deficiency Type I Argininosuccinic Aciduria 1 3-Hydroxy Long Chain Acyl-CoA Dehydrogenase 5-Oxoprolinuria 1 Deficiency Carbamoylphosphate Synthetase Deficiency 1 2,4-Dienoyl-CoA Reductase Deficiency Citrullinemia Medium Chain Acyl-CoA Dehydrogenase Deficiency Homocystinuria Multiple Acyl-CoA Dehydrogenase Deficiency Hypermethioninemia Neonatal Carnitine Palmitoyl Transferase Deficiency Hyperammonemia, Hyperornithinemia, Homocitrullinuria Type II Syndrome1 1 Short Chain Acyl-CoA Dehydrogenase Deficiency Hyperornithinemia with Gyral Atrophy Short Chain Hydroxy Acyl-CoA Dehydrogenase Maple Syrup Urine Disease Deficiency Phenylketonuria Trifunctional Protein Deficiency Classical/Hyperphenylalaninemia Very Long Chain Acyl-CoA Dehydrogenase Deficiency Biopterin Cofactor Deficiencies Tyrosinemia Organic Acid Disorders Transient Neonatal Tyrosinemia 2 Tyrosinemia Type I 3-Hydroxy-3-Methylglutaryl-CoA Lyase Deficiency Tyrosinemia Type II Glutaric Acidemia Type I Tyrosinemia Type III Isobutyryl-CoA Dehydrogenase Deficiency Isovaleric Acidemia 2-Methylbutyryl-CoA Dehydrogenase Deficiency 3-Methylcrotonyl-CoA Carboxylase Deficiency Other Observations 3-Methylglutaconyl-CoA Hydratase Deficiency Methylmalonic Acidemias Hyperalimentation Methylmalonyl-CoA Mutase Deficiency
    [Show full text]
  • Arginine-Provider-Fact-Sheet.Pdf
    Arginine (Urea Cycle Disorder) Screening Fact Sheet for Health Care Providers Newborn Screening Program of the Oklahoma State Department of Health What is the differential diagnosis? Argininemia (arginase deficiency, hyperargininemia) What are the characteristics of argininemia? Disorders of arginine metabolism are included in a larger group of disorders, known as urea cycle disorders. Argininemia is an autosomal recessive inborn error of metabolism caused by a defect in the final step in the urea cycle. Most infants are born to parents who are both unknowingly asymptomatic carriers and have NO known history of a urea cycle disorder in their family. The incidence of all urea cycle disorders is estimated to be about 1:8,000 live births. The true incidence of argininemia is not known, but has been estimated between 1:350,000 and 1:1,000,000. Argininemia is usually asymptomatic in the neonatal period, although it can present with mild to moderate hyperammonemia. Untreated, argininemia usually progresses to severe spasticity, loss of ambulation, severe cognitive and intellectual disabilities and seizures Lifelong treatment includes a special diet, and special care during times of illness or stress. What is the screening methodology for argininemia? 1. An amino acid profile by Tandem Mass Spectrometry (MS/MS) is performed on each filter paper. 2. Arginine is the primary analyte. What is an in-range (normal) screen result for arginine? Arginine less than 100 mol/L is NOT consistent with argininemia. See Table 1. TABLE 1. In-range Arginine Newborn Screening Results What is an out-of-range (abnormal) screen for arginine? Arginine > 100 mol/L requires further testing.
    [Show full text]
  • What Disorders Are Screened for by the Newborn Screen?
    What disorders are screened for by the newborn screen? Endocrine Disorders The endocrine system is important to regulate the hormones in our bodies. Hormones are special signals sent to various parts of the body. They control many things such as growth and development. The goal of newborn screening is to identify these babies early so that treatment can be started to keep them healthy. To learn more about these specific disorders please click on the name of the disorder below: English: Congenital Adrenal Hyperplasia Esapnol Hiperplasia Suprarrenal Congenital - - http://www.newbornscreening.info/Parents/otherdisorders/CAH.html - http://www.newbornscreening.info/spanish/parent/Other_disorder/CAH.html - Congenital Hypothyroidism (Hipotiroidismo Congénito) - http://www.newbornscreening.info/Parents/otherdisorders/CH.html - http://www.newbornscreening.info/spanish/parent/Other_disorder/CH.html Hematologic Conditions Hemoglobin is a special part of our red blood cells. It is important for carrying oxygen to the parts of the body where it is needed. When people have problems with their hemoglobin they can have intense pain, and they often get sick more than other children. Over time, the lack of oxygen to the body can cause damage to the organs. The goal of newborn screening is to identify babies with these conditions so that they can get early treatment to help keep them healthy. To learn more about these specific disorders click here (XXX). - Sickle Cell Anemia (Anemia de Célula Falciforme) - http://www.newbornscreening.info/Parents/otherdisorders/SCD.html - http://www.newbornscreening.info/spanish/parent/Other_disorder/SCD.html - SC Disease (See Previous Link) - Sickle Beta Thalassemia (See Previous Link) Enzyme Deficiencies Enzymes are special proteins in our body that allow for chemical reactions to take place.
    [Show full text]
  • The Pharmabiotic for Phenylketonuria: Development of a Novel Therapeutic
    University of South Carolina Scholar Commons Senior Theses Honors College Spring 2019 The hP armabiotic for Phenylketonuria: Development of a Novel Therapeutic Chloé Elizabeth LeBegue University of South Carolina, [email protected] Follow this and additional works at: https://scholarcommons.sc.edu/senior_theses Part of the Alternative and Complementary Medicine Commons, Amino Acids, Peptides, and Proteins Commons, Biochemical Phenomena, Metabolism, and Nutrition Commons, Biotechnology Commons, Congenital, Hereditary, and Neonatal Diseases and Abnormalities Commons, Digestive, Oral, and Skin Physiology Commons, Digestive System Diseases Commons, Enzymes and Coenzymes Commons, Genetic Phenomena Commons, Medical Biotechnology Commons, Medical Genetics Commons, Medical Nutrition Commons, Medical Pharmacology Commons, Nutritional and Metabolic Diseases Commons, Other Pharmacy and Pharmaceutical Sciences Commons, Pharmaceutical Preparations Commons, Pharmaceutics and Drug Design Commons, and the Preventive Medicine Commons Recommended Citation LeBegue, Chloé Elizabeth, "The hP armabiotic for Phenylketonuria: Development of a Novel Therapeutic" (2019). Senior Theses. 267. https://scholarcommons.sc.edu/senior_theses/267 This Thesis is brought to you by the Honors College at Scholar Commons. It has been accepted for inclusion in Senior Theses by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. THE PHARMABIOTIC FOR PHENYLKETONURIA: DEVELOPMENT OF A NOVEL THERAPEUTIC By Chloé Elizabeth
    [Show full text]
  • Fatal Propionic Acidemia: a Challenging Diagnosis
    Issue: Ir Med J; Vol 112; No. 7; P980 Fatal Propionic Acidemia: A Challenging Diagnosis A. Fulmali, N. Goggin 1. Department of Paediatrics, NDDH, Barnstaple, UK 2. Department of Paediatrics, UHW, Waterford, Ireland Dear Sir, We present a two days old neonate with severe form of propionic acidemia with lethal outcome. Propionic acidemia is an AR disorder, presents in the early neonatal period with progressive encephalopathy and death can occur quickly. A term neonate admitted to NICU on day 2 with poor feeding, lethargy and dehydration. Parents are non- consanguineous and there was no significant family history. Prenatal care had been excellent. Delivery had been uneventful. No resuscitation required with good APGAR scores. Baby had poor suck, lethargy, hypotonia and had lost about 13% of the birth weight. Initial investigations showed hypoglycemia (2.3mmol/L), uremia (8.3mmol/L), hypernatremia (149 mmol/L), severe metabolic acidosis (pH 7.24, HCO3 9.5, BE -18.9) with high anion gap (41) and ketonuria (4+). Hematologic parameters, inflammatory markers and CSF examination were unremarkable. Baby received initial fluid resuscitation and commenced on IV antibiotics. Generalised seizures became eminent at 70 hours of age. Loading doses of phenobarbitone and phenytoin were given. Hepatomegaly of 4cm was spotted on day 4 of life. Very soon baby became encephalopathic requiring invasive ventilation. At this stage clinical features were concerning for metabolic disorder and hence was transferred to tertiary care centre where further investigations showed high ammonia level (1178 μg/dl) and urinary organic acids were suggestive of propionic acidemia. Specific treatment for hyperammonemia and propionic acidemia was started.
    [Show full text]
  • List of Toxic Chemicals Within the Glycol Ethers Category
    United States Office of Environmental Revised December 2000 Environmental Protection Information EPA 745-R-00-004 Agency Washington, DC 20460 TOXICS RELEASE INVENTORY List of Toxic Chemicals within the Glycol Ethers Category Section 313 of the Emergency Planning and Community Right-to-Know Act (EPCRA) requires certain facilities manufacturing, processing, or otherwise using listed toxic chemicals to report their environmental releases of such chemicals annually. Beginning with the 1991 reporting year, such facilities also must report pollution prevention and recycling data for such chemicals, pursuant to section 6607 of the Pollution Prevention Act, 42 U.S.C. 13106. When enacted, EPCRA section 313 established an initial list of toxic chemicals that was comprised of more than 300 chemicals and 20 chemical categories. EPCRA section 313(d) authorizes EPA to add chemicals to or delete chemicals from the list, and sets forth criteria for these actions. CONTENTS Section 1. Introduction ...................................................... 3 Section 2. CAS Number List of Some Chemicals within the Glycol Ethers Category ........ 6 Section 3. CAS Number List of Some Mixtures That Contain Glycol Ethers within the Category .............................................. 185 Section 4. CAS Number List of Some Oligomeric or Polymeric Chemicals That Might Contain Glycol Ether Components within the Category .......................... 187 FOREWORD This document is an updated version of the previous document, EPA 745-R-99-006, June 1999. This version has the following updates: • The titles to Table 1 on page 6, Table 2 on page 185, and Table 3 on 187 are modified; and • The CAS number of second listing in Table 3 (Poly(oxy-1,2-ethanediyl), .alpha.- (phenylsulfonyl)-.omega.-methoxy-) on page 187 is changed from 7664-41-7 to 67584-43-4.
    [Show full text]
  • AMERICAN ACADEMY of PEDIATRICS Reimbursement For
    AMERICAN ACADEMY OF PEDIATRICS POLICY STATEMENT Organizational Principles to Guide and Define the Child Health Care System and/or Improve the Health of All Children Committee on Nutrition Reimbursement for Foods for Special Dietary Use ABSTRACT. Foods for special dietary use are recom- DEFINITION OF FOODS FOR SPECIAL mended by physicians for chronic diseases or conditions DIETARY USE of childhood, including inherited metabolic diseases. Al- The US Food and Drug Administration, in the though many states have created legislation requiring Code of Federal Regulations,2 defines special dietary reimbursement for foods for special dietary use, legisla- use of foods as the following: tion is now needed to mandate consistent coverage and reimbursement for foods for special dietary use and re- a. Uses for supplying particular dietary needs that lated support services with accepted medical benefit for exist by reason of a physical, physiologic, patho- children with designated medical conditions. logic, or other condition, including but not limited to the conditions of diseases, convalescence, preg- ABBREVIATION. AAP, American Academy of Pediatrics. nancy, lactation, allergic hypersensitivity to food, [and being] underweight and overweight; b. Uses for supplying particular dietary needs which BACKGROUND exist by reason of age, including but not limited to pecial foods are recommended by physicians to the ages of infancy and childhood; foster normal growth and development in some c. Uses for supplementing or fortifying the ordinary or usual diet with any vitamin, mineral, or other children and to prevent serious disability and S dietary property. Any such particular use of a even death in others. Many of these special foods are food is a special dietary use, regardless of whether technically specialized formulas for which there may such food also purports to be or is represented for be a relatively small market, which makes them more general use.
    [Show full text]