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Infants Diagnosed with Spinal Muscular Atrophy and 4 SMN2 Copies through Newborn Screening –Opportunity or Burden?

Wolfgang Müller-Felber, Katharina Vill, Oliver Schwartz, Dieter Gläser, Uta Nennstiel, Brunhilde Wirth, Siegfried Burggraf, Wulf Röschinger, Marc Becker, Jürgen Durner, Katja Eggermann, Christine Müller (+5 others)
2020 Journal of Neuromuscular Diseases  

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Although the value of newborn screening (NBS) for early detection and treatment opportunity in SMA patients is generally accepted, there is still an ongoing discussion about the best strategy in children with 4 and more copies of the SMN2 gene. This gene is known to be the most important but not the only disease modifier.In our SMA-NBS pilot project in Germany comprising 278,970 infants screened between January 2018 and November 2019 were 38 positive cases with a homozygous SMN1 deletion. 40%
more » ... them had 4 or more SMN2 copies. The incidence for homozygous SMN1 deletion was 1 : 7350, which is within the known range of SMA incidence in Germany.Of the 15 SMA children with 4 SMN2 copies, one child developed physical signs of SMA by the age of 8 months. Two children had affected siblings with SMA Type III, who were diagnosed only after detection of the index patient in the NBS. One had a positive family history with an affected aunt (onset of disease at the age of 3 years). Three families were lost to medical follow up; two because of socioeconomic reasons and one to avoid the psychological stress associated with the appointments.Decisions on how to handle patients with 4 SMN2 copies are discussed in the light of the experience gathered from our NBS pilot SMA program.
doi:10.3233/jnd-200475 pmid:32144995 fatcat:2raogc5fz5hdziyxd4ir5h3ziq
Citation

Wolfgang Müller-Felber, Katharina Vill, Oliver Schwartz, Dieter Gläser, Uta Nennstiel, Brunhilde Wirth, Siegfried Burggraf, Wulf Röschinger, Marc Becker, Jürgen Durner, Katja Eggermann, Christine Müller, Iris Hannibal, Bernd Olgemöller, Ulrike Schara, Astrid Blaschek, Heike Kölbel. "Infants Diagnosed with Spinal Muscular Atrophy and 4 SMN2 Copies through Newborn Screening –Opportunity or Burden?." Journal of Neuromuscular Diseases 7.2 (2020) 1-9