首页|Genome Analysis in Sick Neonates and Infants: High-yield Phenotypes and Contribution of Small Copy Number Variations

Genome Analysis in Sick Neonates and Infants: High-yield Phenotypes and Contribution of Small Copy Number Variations

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  • NSTL
  • Elsevier
? 2022 The Author(s)Objective: To delineate the diagnostic efficacy of medical exome, whole exome, and whole genome sequencing according to primary symptoms, the contribution of small copy number variations, and the impact of molecular diagnosis on clinical management. Study design: This was a prospective study of 17 tertiary care centers in Japan, conducted between April 2019 and March 2021. Critically ill neonates and infants less than 6 months of age were recruited in neonatal intensive care units and in outpatient clinics. The patients underwent medical exome, whole exome, or whole genome sequencing as the first tier of testing. Patients with negative results after medical exome or whole exome sequencing subsequently underwent whole genome sequencing. The impact of molecular diagnosis on clinical management was evaluated through contacting primary care physicians. Results: Of the 85 patients, 41 (48%) had positive results. Based on the primary symptoms, patients with metabolic phenotypes had the highest diagnostic yield (67%, 4/6 patients), followed by renal (60%, 3/5 patients), and neurologic phenotypes (58%, 14/24 patients). Among them, 4 patients had pathogenic small copy number variations identified using whole genome sequencing. In the 41 patients with a molecular diagnosis, 20 (49%) had changes in clinical management. Conclusions: Genome analysis for critically ill neonates and infants had a high diagnostic yield for metabolic, renal, and neurologic phenotypes. Small copy number variations detected using whole genome sequencing contributed to the overall molecular diagnosis in 5% of all the patients. The resulting molecular diagnoses had a significant impact on clinical management.

congenital disorderscopy number variationsexome sequencinginfantintensive caremetabolic disordersneonatewhole genome sequencing

Suzuki H.、Nozaki M.、Yoshihashi H.、Imagawa K.、Kajikawa D.、Yamada M.、Yamaguchi Y.、Morisada N.、Eguchi M.、Ohashi S.、Ninomiya S.、Seto T.、Tokutomi T.、Toyoshima K.、Kondo M.、Inui A.、Kurosawa K.、Kosaki R.、Ito Y.、Hida M.、Okamoto N.、Kosaki K.、Takenouchi T.

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Center for Medical Genetics Keio University School of Medicine

Department of Neonatal Medicine Osaka Women's and Children's Hospital

Department of Genetics Tokyo Metropolitan Children's Medical Center

Department of Child Health Faculty of Medicine University of Tsukuba

Department of Neonatology Ibaraki Children's Hospital

Department of Clinical Genetics Gunma Children's Medical Center

Department of Clinical Genetics Hyogo Prefectural Kobe Children's Hospital

Department of Neonatology Tokyo Metropolitan Bokutoh Hospital

Department of Neonatology Tokyo Metropolitan Ohtsuka Hospital

Department of Clinical Genetics Kurashiki Central Hospital

Department of Medical Genetics Osaka City University Hospital

Department of Clinical Genetics Iwate Medical University

Department of Neonatology Kanagawa Children's Medical Center

Department of Neonatology Tokyo Metropolitan Children's Medical Center

Department of Pediatric Hepatology and Gastroenterology Saiseikai Yokohama-shi Tobu Hospital

Division of Medical Genetics Kanagawa Children's Medical Center

Division of Medical Genetics National Center for Child Health and Development

Division of Neonatology National Center for Child Health and Development

Department of Pediatrics Keio University School of Medicine

Department of Medical Genetics Osaka Women's and Children's Hospital

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2022

10.1016/j.jpeds.2022.01.033

The Journal of pediatrics

The Journal of pediatrics

ISSN：0022-3476
年,卷(期)：2022.244
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