[Screening for congenital hypothyroidism, phenylketonuria, galactosemia and biotinidase deficiency in a sample of mentally retarded patients in the city of Havana]. / Cribado de hipotiroidismo congénito, fenilcetonuria, galactosemia y deficiencia de biotinidasa en una muestra de retrasados mentales de Ciudad de La Habana.

INTRODUCTION: Congenital hypothyroidism (CH), phenylketonuria (PKU), galactosemia (GAL) and biotinidase deficiency (BD) are innate errors in metabolism that share varying degrees of mental retardation (MR) as a common characteristic. AIMS. The aim of our study was to screen individuals with MR of unknown origin for CH, PKU, GAL and BD. PATIENTS AND METHODS: Venous blood samples were collected on SS 903 specimen collection paper from 55 individuals with MR of unspecific origin born within the period 1977 1997. CH diagnosis was performed through determination of total thyroxine (T4) and thyroid stimulating hormone (TSH), using the UMELISA T4 and neonatal TSH reagent kits, respectively, and the detection of PKU, GAL and BD was conducted by determining phenylalanine (Phe), total galactose (Gal) and biotinidase enzyme activity (Biot) using UMTEST PKU, GAL and BIOTINIDASA. RESULTS: The mean values obtained for the analytes that were evaluated were: 0.8 mUI of TSH/L of total blood (EEM: 0.2), 113.1 nmol of T4/L of serum (EEM: 5.4), 67.7 mol of Phe/L of total blood (EEM: 0.1), 0.1 mmol of Gal/L of total blood (EEM: 0.01), and Biot activity was normal in all cases. CONCLUSIONS: This study enabled us to determine the T4, TSH, Phe and Gal levels in a sample from the Cuban population with MR of unknown causation. In addition, slightly higher levels of T4 were found in children who had hyperkinesis

Cribado de hipotiroidismo congénito, fenilcetonuria, galactosemia y deficiencia de biotinidasa en una muestra de retrasados mentales de Ciudad de La Habana / Screening for congenital hypothyroidism, phenylketonuria, galactosemia and biotinidase deficiency in a sample of mentaly retarded patients in the city of Havana

Introducción.El hipotiroidismo congénito (HC), la fenilcetonuria (FCU), la galactosemia (GAL) y la deficiencia de biotinidasa (DB) son errores innatos del metabolismo que tienen como característica común el retraso mental (RM) de diferentes gradaciones. Objetivo. Realizar el cribado de HC, FCU, GAL y DB en individuos con RM de etiología desconocida. Pacientes y métodos. Se recolectaron muestras de sangre venosa en tarjetas de papel de filtro S&S 903 de 55 individuos con RM sin etiología específica, nacidos en el período de 1977-1997. El diagnóstico de HC se realizó mediante las determinaciones de tiroxina total (T4) y hormona estimulante del tiroides (TSH), con los estuches de reactivos UMELISA T4 y TSH neonatal, respectivamente, y la detección de FCU, GAL y DB mediante las determinaciones de fenilalanina (Phe), galactosa total (Gal) y la actividad de la enzima biotinidasa (Biot), con los UMTEST PKU, GAL y BIOTINIDASA. Resultados. Los valores medios obtenidos para los análitos evaluados fueron: 0,8 mUI de TSH/L de sangre total (EEM: ñ0,2), 113,1 nmol de T4/L de suero (EEM: ñ5,4), 67,7 µmol de Phe/L de sangre total (EEM: ñ0,1), 0,1 mmol de Gal/L de sangre total (EEM:ñ0,01) y la actividad de Biot fue normal en todos los casos. Conclusiones. Este estudio permitió conocer los niveles de T4, TSH, Phe y Gal en una muestra de población cubana con RM de etiología desconocida. Además, se encontraron niveles ligeramente elevados de T4 en niños que tenían hipercinesia (AU)

Etiological characterization of 512 severely mentally retarded institutionalized patients in havana.

OBJECTIVE: To investigate etiological factors in severe mental retardation (SMR). METHODS: An etiological study is presented of 512 SMR patients in five specialized institutions in Havana. RESULTS: Prenatal, perinatal and postnatal causes were apparent in 58.0, 24.8 and 11.1% of the patients, respectively; infantile psychosis was determined in only 0.4%. The remaining 5.6% were classified as having SMR of undeterminable origin, i.e. patients with apparently normal pre-, peri- and postnatal histories who had neither dysmorphism nor affected first-degree relatives, and had a normal karyotype and metabolic screen. Among prenatal causes, genetic factors were the most frequent (82.8%), while environmental factors were apparent in only 5.3% of these cases. Of the cases with prenatal genetic etiology, chromosomal aberrations were present in 86.5% (Down syndrome 96.2% and 3.7% other chromosomal aberrations), monogenic disorders in 11.3% [neurocutaneous diseases (32.1%) and fragile X syndrome (25%) were the most frequent], and multifactorial disorders in 2.0%. Thirty-five patients (11.7%) presented multiple congenital anomalies of 'prenatal unknown' causes. The latter group may include unidentifiable chromosomal aberrations, uniparental disomy, de novo mutations and multifactorial or teratogenic factors. CONCLUSION: Accurate determination of the etiology of SMR is important not only for genetic counseling purposes, but also in identifying prenatal events which make infants more vulnerable to perinatal risk factors.

Evidence of a third locus in X-linked recessive spastic paraplegia.

We have investigated a family with severe X-linked spastic paraplegia and assigned the disease locus to Xq11.2-q23 by linkage and haplotype analysis. This region harbors the gene coding for proteolipid protein, which is mutated in one of the two established forms of X-linked spastic paraplegia, i.e., SPG2. We have performed extensive mutation analysis of this gene. Our failure to detect a mutation in this family suggests a third locus in X-linked recessive spastic paraplegia.

[Partial trisomy of chromosome 15 with new phenotypic manifestations]. / Trisomía parcial del cromosoma 15 con nuevas manifestaciones fenotípicas.

A patient with a 15 partial trisomy and a 4 target chromosome in 100% of metaphases is presented. Phenotypic manifestations not previously described were observed such as macrocephally, long face, low implantation of ears, narrow forehead, epicanthal fold, copious eyebrows and synophrys, short nasolabial distance, convergent strabismus, delayed bucal eruption, long neck, hypertrophy of thenar and hypothenar bulging and articular hypermobility. The eyeground was degeneratively myopic. This case makes more extensive the variety of clinical manifestations of this disease.

Trisomía parcial del cromosoma 15 con nuevas manifestaciones fenotípicas. / [Partial trisomy of chromosome 15 with new phenotypic manifestations]

A patient with a 15 partial trisomy and a 4 target chromosome in 100

of metaphases is presented. Phenotypic manifestations not previously described were observed such as macrocephally, long face, low implantation of ears, narrow forehead, epicanthal fold, copious eyebrows and synophrys, short nasolabial distance, convergent strabismus, delayed bucal eruption, long neck, hypertrophy of thenar and hypothenar bulging and articular hypermobility. The eyeground was degeneratively myopic. This case makes more extensive the variety of clinical manifestations of this disease.

Alteraciones esqueléticas en el síndrome de Marfan. Estudio de una casuística / Skeletal disorders in Marfan's syndrome. Study of a casuistic

Se revisaron las historias clínicas de 20 pacientes afectados por el síndrome de Marfan, procedentes de diferentes hospitales de Ciudad de La Habana. Se recogieron los datos correspondientes a las alteraciones musculoesqueléticas. Se computaron éstos en cuadros. Se correlacionó la revisión, con las series de otros autores, y se llegó a conclusiones acerca de los individuos de este grupo (AU)