A retrospective study of small molecule disorder types of metabolism in paediatric patients in intensive care

Abstract

Background: Although inborn errors of metabolism (IEM) are rare individually, collectively IEM cause substantial morbidity and mortality and the diagnosis is challenging. Aims: To analyse epidemiological and clinical data, final diagnosis and clinical outcomes of patients with a suspectediagnosis of IEM (small molecule disorders type) admitted to a paediatric intensive care unit (PICU). Methods: We collected and analysed medical records data of all patients admitted to the PICU at Alexandria University Children’s Hospital, from January 2010 to December 2014, with a suspected or confirmed diagnosis of small molecule disorders, including clinical presentations, laboratory results and clinical outcomes. Results: A total of 34 patients had a suspected or confirmed diagnosis of small molecule disorders at PICU admission. Diagnosis was confirmed in 22.7% of suspected cases at admission and in 25% of suspected cases during PICU stay. Con-sanguineous marriage was found in 50% of cases with confirmed small molecule disorders. Conclusions: A high index of suspicion is important for diagnosing and categorizing small molecule disorders in screening of high-risk individuals in low-and middle-income countries.