2007
DOI: 10.1373/clinchem.2007.087775
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Rapid 2nd-Tier Test for Measurement of 3-OH-Propionic and Methylmalonic Acids on Dried Blood Spots: Reducing the False-Positive Rate for Propionylcarnitine during Expanded Newborn Screening by Liquid Chromatography–Tandem Mass Spectrometry

Abstract: Background:The expansion of newborn screening programs has increased the number of newborns diagnosed with inborn errors of metabolism in the presymptomatic phase, but it has also increased the number of costly, stress-producing false-positive results. Because propionylcarnitine (C3) is one of the analytes most frequently responsible for false-positive results, we aimed to develop a rapid liquid chromatographytandem mass spectrometry (LC-MS/MS) method to identify free methylmalonic (MMA) and 3-OH propionic (3O… Show more

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Cited by 109 publications
(97 citation statements)
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References 15 publications
(11 reference statements)
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“…For example, acylcarnitines are unstable if stored at room temperature for more than 2 weeks on DBS due to hydrolysis, but they are stable for at least 330 days when stored at ≤−18°C . Without establishing the analyte storage stability coverage (from sample collection to analysis), a retrospective reanalysis of the study samples might not be confi rmative for any purpose, especially for newborn screening, for which the confi rmatory analysis (secondtier test) is often conducted, but only after the initial population screening Lai et al, 2001Lai et al, , 2002la Marca et al, 2007la Marca et al, , 2008aMatern et al, 2007). Stability assessment.…”
Section: Stabilitymentioning
confidence: 99%
See 1 more Smart Citation
“…For example, acylcarnitines are unstable if stored at room temperature for more than 2 weeks on DBS due to hydrolysis, but they are stable for at least 330 days when stored at ≤−18°C . Without establishing the analyte storage stability coverage (from sample collection to analysis), a retrospective reanalysis of the study samples might not be confi rmative for any purpose, especially for newborn screening, for which the confi rmatory analysis (secondtier test) is often conducted, but only after the initial population screening Lai et al, 2001Lai et al, , 2002la Marca et al, 2007la Marca et al, , 2008aMatern et al, 2007). Stability assessment.…”
Section: Stabilitymentioning
confidence: 99%
“…Furthermore, the possible in-source fragmentation in the case that the target analyte is a derivative of another intact biomarker molecule and natural isotope contribution might add another challenge to MS/MS (infusion or fl ow injection) only assays (Garg and Dasouki, 2006;Piraud et al, 2003). Consequently, LC-MS/MS has been increasingly explored in the confi rmatory analysis (second-tier test) of those 'diffi cult' biomarker molecules, resulting in a reduced false-positive rate (Janzen et al, 2007;Lacey et al, 2004;la Marca et al, 2007 and2008a;Matern et al, 2007;Minutti et al, 2004).…”
Section: Introductionmentioning
confidence: 99%
“…PA is included in the NBS core panel, to rule out a subset of C3-related metabolic disorders resulting from propionate accumulation (PA, methylmalonic aciduria (MMA), certain cobalamin (Cbl) disorders). C3 is not specific for PA and a second-tier strategies analyzing methylmalonic acid, 3-hydroxypropionic acid, and 2-methylcitric acid from the initial DBS have been developed (la Marca et al 2007;Lindner et al 2008;Matern et al 2007). Many laboratories use ratios of C3 to other acylcarnitine species (C2, C0, C16) or to methionine to improve specificity and sensitivity of C3 test (Wikoff et al 2007).…”
Section: Discussionmentioning
confidence: 99%
“…In 2011 in Tuscany region, ADA SCID biomarkers were included in the panel of expanded NBS; also in this case a second tier test can be performed when elevated concentration of purines metabolites are detected [51].…”
Section: Second Tier Testsmentioning
confidence: 99%