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Reduction of the false-positive rate in newborn screening by implementation of MS/MS-based second-tier tests: The Mayo Clinic experience (2004–2007)

  • Newborn Screening
  • Published:
Journal of Inherited Metabolic Disease

Summary

The continued expansion of newborn screening programmes to include additional conditions increases the responsibility of newborn screening laboratories to provide testing with the highest sensitivity and specificity to allow for identification of affected patients while minimizing the false-positive rate. Some assays and analytes are particularly problematic. Over recent years, our laboratory tried to improve this situation by developing second-tier tests to reduce false-positive results in the screening for congenital adrenal hyperplasia (CAH), tyrosinaemia type I, methylmalonic acidaemias, homocystinuria, and maple syrup urine disease (MSUD). Beginning in 2004, this approach was applied to Mayo’s newborn screening programme and resulted in a false-positive rate of 0.09%, a positive predictive value of 41%, and a positive detection rate of 1 affected case in 1672 babies screened.

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References

  • Abdenur JE, Chamoles NA, Guinle AE, Schenone AB, Fuertes AN (1998) Diagnosis of isovaleric acidaemia by tandem mass spectrometry: false positive result due to pivaloylcarnitine in a newborn screening programme. J Inherit Metab Dis 21: 624–630.

    Article  PubMed  CAS  Google Scholar 

  • Allard P, Grenier A, Korson MS, Zytkovicz TH (2004) Newborn screening for hepatorenal tyrosinaemia by tandem mass spectrometry: analysis of succinylacetone extracted from dried blood spots. Clin Biochem 37: 1010–1015.

    Article  PubMed  CAS  Google Scholar 

  • Chace DH, DiPerna JC, Kalas TA, Johnson RW, Naylor EW (2001) Rapid diagnosis of methylmalonic and propionic acidemias: quantitative tandem mass spectrometric analysis of propionylcarnitine in filter-paper blood specimens obtained from newborns. Clin Chem 47: 2040–2044.

    PubMed  CAS  Google Scholar 

  • Chace DH, Kalas TA, Naylor EW (2003) Use of tandem mass spectrometry for multianalyte screening of dried blood specimens from newborns. Clin Chem 49: 1797–1817.

    Article  PubMed  CAS  Google Scholar 

  • Chan K, Puck JM (2005) Development of population-based newborn screening for severe combined immunodeficiency. J Allergy Clin Immunol 115: 391–398.

    Article  PubMed  Google Scholar 

  • Drousiotou A, Ioannou P, Georgiou T, et al (1998) Neonatal screening for Duchenne muscular dystrophy: a novel semiquantitative application of the bioluminescence test for creatine kinase in a pilot national program in Cyprus. Genet Test 2: 55–60.

    Article  PubMed  CAS  Google Scholar 

  • Ensenauer R, Vockley J, Willard JM, et al (2004) A common mutation is associated with a mild, potentially asymptomatic phenotype in patients with isovaleric acidemia diagnosed by newborn screening. Am J Hum Genet 75: 1136–1142.

    Article  PubMed  CAS  Google Scholar 

  • Escolar ML, Poe MD, Provenzale JM, et al (2005) Transplantation of umbilical-cord blood in babies with infantile Krabbe’s disease. N Engl J Med 352: 2069–2081.

    Article  PubMed  CAS  Google Scholar 

  • Green NS, Pass KA (2005) Neonatal screening by DNA microarray: spots and chips. Nat Rev Genet 6: 147–151.

    Article  PubMed  CAS  Google Scholar 

  • Grenier A, Laberge C (1996) Neonatal screening for tyrosinaemia type I and early sampling (abstract). Third Meeting of the International Society for Neonatal Screening (abstract book), 70.

  • Gurian EA, Kinnamon DD, Henry JJ, Waisbren SE (2006) Expanded newborn screening for biochemical disorders: the effect of a false-positive result. Pediatrics 117: 1915–1921.

    Article  PubMed  Google Scholar 

  • Hubbard WC, Moser AB, Tortorelli S, Liu A, Jones D, Moser HW (2006) Combined liquid chromatography–tandem mass spectrometry as an analytical method for high-throughput screening for X-linked adrenoleukodystrophy and other peroxisomal disorders: preliminary findings. Mol Genet Metab 89: 185–187.

    Article  PubMed  CAS  Google Scholar 

  • Kirk K, Steckel T, King P, Kline D, Rhoades E, Copeland K (2007) A second-tier screening approach for CAH: Oklahoma’s experience. Paper presented at 2007 Newborn Screening and Genetic Testing Symposium. Minneapolis, MN.

  • Kroll CA, Ferber MJ, Dawson BD, et al (2006) Retrospective determination of ceruloplasmin in newborn screening blood spots of patients with Wilson disease. Mol Genet Metab 89: 134–138.

    Article  PubMed  CAS  Google Scholar 

  • Lacey JM, Minutti CZ, Magera MJ, et al (2004) Improved specificity of newborn screening for congenital adrenal hyperplasia by second-tier steroid profiling using tandem mass spectrometry. Clin Chem 50: 621–625.

    Article  PubMed  CAS  Google Scholar 

  • Li Y, Scott CR, Chamoles NA, et al (2004) Direct multiplex assay of lysosomal enzymes in dried blood spots for newborn screening. Clin Chem 50: 1785–1796.

    Article  PubMed  CAS  Google Scholar 

  • Magera MJ, Gunawardena ND, Hahn SH, et al (2006) Quantitative determination of succinylacetone in dried blood spots for newborn screening of tyrosinaemia type I. Mol Genet Metab 88: 16–21.

    Article  PubMed  CAS  Google Scholar 

  • Matern D, He M, Berry SA, Rinaldo P, et al (2003) Prospective diagnosis of 2-methylbutyryl-CoA dehydrogenase deficiency in the hmong population by newborn screening using tandem mass spectrometry. Pediatrics 112: 74–78.

    Article  PubMed  Google Scholar 

  • Matern D, Cuthbert CD, Magera MJ, Tortorelli S, Hahn S, Rinaldo P (2005) A reporting algorithm for elevated propionylcarnitine (C3) including a 2nd tier test for methylmalonic acid and homocysteine. Paper presented at 2005 Newborn Screening and Genetic Testing Symposium. Portland, OR.

  • McGhee SA, Stiehm ER, Cowan M, Krogstad P, McCabe ER (2005) Two-tiered universal newborn screening strategy for severe combined immunodeficiency. Mol Genet Metab 86: 427–430.

    Article  PubMed  CAS  Google Scholar 

  • Meikle PJ, Grasby DJ, Dean CJ, et al (2006) Newborn screening for lysosomal storage disorders. Mol Genet Metab 88: 307–314.

    Article  PubMed  CAS  Google Scholar 

  • Minutti CZ, Lacey JM, Magera MJ, et al (2004) Steroid profiling by tandem mass spectrometry improves the positive predictive value of newborn screening for congenital adrenal hyperplasia. J Clin Endocrinol Metab 89: 3687–3693.

    Article  PubMed  CAS  Google Scholar 

  • Mitchell GA, Grompe M, Lambert M, Tanguay RM (2001) Hypertyrosinaemia. In: Scriver CR, Beaudet AL, Sly WS, Valle D, eds; Childs B, Kinzler KW, Vogelstein B, assoc. eds. The Metabolic and Molecular Bases of Inherited Disease, 8th edn. New York: McGraw-Hill, 1777–1805.

    Google Scholar 

  • Peterschmitt MJ, Simmons JR, Levy HL (1999) Reduction of false negative results in screening of newborns for homocystinuria. N Engl J Med 341: 1572–1576.

    Article  PubMed  CAS  Google Scholar 

  • Rashed MS, Al-Ahaidib LY, Al-Dirbashi OY, et al (2005) Tandem mass spectrometric assay of succinylacetone in urine for the diagnosis of hepatorenal tyrosinaemia. Anal Biochem 339: 310–317.

    Article  PubMed  CAS  Google Scholar 

  • Rife M, Mallolas J, Badenas C, et al (2002) Pilot study for the neonatal screening of fragile X syndrome. Prenat Diagn 22: 459–462.

    Article  PubMed  CAS  Google Scholar 

  • Rinaldo P, Zafari S, Tortorelli S, Matern D (2006) Making the case for objective performance metrics in newborn screening by tandem mass spectrometry. Ment Retard Dev Disabil Res Rev 12: 255–261.

    Article  PubMed  Google Scholar 

  • Saavedra-Matiz C, Orsini J, Morrissey M, et al (2007) Newborn screening for Krabbe disease in New York State: The first months. Paper presented at 2007 Newborn Screening and Genetic Testing Symposium. Minneapolis, MN.

  • Sander J, Janzen N, Peter M, et al (2006) Newborn screening for hepatorenal tyrosinaemia: Tandem mass spectrometric quantification of succinylacetone. Clin Chem 52: 482–487.

    Article  PubMed  CAS  Google Scholar 

  • Schulze A, Frommhold D, Hoffmann GF, Mayatepek E (2001) Spectrophotometric microassay for delta-aminolevulinate dehydratase in dried-blood spots as confirmation for hereditary tyrosinaemia type I. Clin Chem 47: 1424–1429.

    PubMed  CAS  Google Scholar 

  • Waisbren SEP, Albers SMD, Amato SMD, et al (2003) Effect of expanded newborn screening for biochemical genetic disorders on child outcomes and parental stress. JAMA 290: 2564–2572.

    Article  PubMed  CAS  Google Scholar 

  • Wong T, Shackleton CH, Covey TR, Ellis G (1992) Identification of the steroids in neonatal plasma that interfere with 17 alpha-hydroxyprogesterone radioimmunoassays. Clin Chem 38: 1830–1837.

    PubMed  CAS  Google Scholar 

  • Zellweger H, Antonik A (1975) Newborn screening for Duchenne muscular dystrophy. Pediatrics 55: 30–34.

    PubMed  CAS  Google Scholar 

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Correspondence to D. Matern.

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Communicating editor: Rodney Pollitt

Competing interests: None declared

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Matern, D., Tortorelli, S., Oglesbee, D. et al. Reduction of the false-positive rate in newborn screening by implementation of MS/MS-based second-tier tests: The Mayo Clinic experience (2004–2007). J Inherit Metab Dis 30, 585–592 (2007). https://doi.org/10.1007/s10545-007-0691-y

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  • DOI: https://doi.org/10.1007/s10545-007-0691-y

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