BackgroundShort-chain acyl-CoA dehydrogenase deficiency (SCADD) represents a rare autosomal recessive inborn metabolic disorder of mitochondrial β-oxidation of monocarboxylic acids. Clinical symptoms can vary from a severe life-threatening condition to an asymptomatic state, reported in the majority of cases. Since the expansion of newborn screenings, more than three hundred probands were admitted for molecular-genetic analysis, most selected because of elevated values of C4-acylcarnitine detected in newborn screenings in Slovakia. Searching for the principal genomic changes led us to the selection of sixty-two patients in whom the presence of sequence variants in the ACADS gene was analysed and correlated with the available biochemical and clinical data.MethodsBiochemical and molecular genetic tests were performed. Acylcarnitine profiles focused on an elevated level of C4-acylcarnitine, which was analysed via tandem mass spectrometry. Urinary organic acids, specifically a quantity of ethylmalonic acid, were determined by gas chromatography/mass spectrometry. The entire coding region of the ACADS gene was sequenced. A low-cost restriction fragment length polymorphism of PCR amplified fragments analysis (PCR-RFLP) of pathogenic variants was introduced and implemented for the molecular-genetic algorithm appropriate for the Slovak population.ResultsOur molecular genetic study was performed on sixty-two patients with a pathological biochemical pattern related to short-chain acyl-CoA dehydrogenase deficiency. In this cohort, we discovered a high occurrence of two rare pathogenic variants—the deletion c.310_312delGAG and the substitution c.1138C>T, with allelic frequencies of 64% and 31%, respectively. Up to 86% of investigated individuals belong to the Roma ethnic group.ConclusionsAnalogous to other countries, SCADD is not included in the newborn screening programme. Based on the exceeded levels of the specific biomarker C4-acylcarnitine as well as ethylmalonic acid, we revealed a high prevalence of short-chain acyl-CoA dehydrogenase deficiency cases, confirmed by the findings of two rare pathogenic variants. A deletion c.310_312delGAG and c.1138C > T substitution in the ACADS gene appear with a high frequency in the Roma ethnic group of Slovakia. Due to the uncertainty of the pathogenicity and clinical consequences, it is important to follow up the morbidity and mortality in these patients over time and evaluate SCADD in relation to clinical outcomes and preventive healthcare recommendations.

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Apolipoprotein E (apoE) is a polymorphic glycoprotein associated with plasma lipoproteins and plays an essential role in the metabolism and clearance of plasma lipids. ApoE can represent the major genetic risk factor in development of premature atherosclerosis, coronary heart disease and late-onset familial and sporadic Alzheimer's Disease (AD). We present a case report of a 51-year old male with suspected AD. After the routine biochemical tests, we performed a Lipoprint System analysis for evaluation of lipoprotein changes and subsequently the molecular-genetic analysis (PCR-RFLP, sequence analysis) of APOE gene. Moderate changes were seen in plasma lipid parameters-an increase of triacylglycerols and a drop of HighDensity Lipoproteins (HDL). Lipoprint System assay revealed a shift of lipoproteins to less dense fractions mainly to Very-Low-Density Lipoproteins (VLDL). The presence of a rare APOE mutation p.Arg136Cys has been detected in patient with severe short-term memory problems and symptoms of dementia. Our case report may open a discussion on possible linking of this rare genotype to neurological pathology and justifying the impact of apoE genotype on lipoprotein metabolism and AD.

OBJECTIVES: The clinical, biochemical and genetic fi ndings in two Slovak patients with glutaric aciduria type I (GAI) are presented. BACKGROUND: GAI is a rare autosomal recessive neuro-metabolic disorder caused by defi ciency of glutarylCoA dehydrogenase, which is involved in the catabolic pathways of lysine, hydroxylysine and tryptophan. This enzymatic defect gives rise to elevated levels of glutaric acid (GA), 3-hydroxyglutaric acid (3-OH-GA) and glutarylcarnitine (C5DC) in body fl uids. METHODS: Biochemical and molecular-genetic tests were performed. Urinary organic acids were analysed by Gas Chromatography/Mass Spectrometry (GC/MS) and the entire coding region of the GCDH gene, including fl anking parts, was sequenced. RESULTS: We found the presence of typical metabolic profi le and novel causal pathogenic variants in both GAI patients. CONCLUSION: We present the fi rst report of two Slovak patients with GAI, which differed in the clinical and biochemical phenotype signifi cantly. They were diagnosed by two distinct approaches -selective and newborn screening. Their diagnosis was complexly confi rmed by biochemical and later on molecular-genetic examinations. Though we agreed with a thesis that early diagnostics might positively infl uenced patientʼs health outcome, contradictory facts should be considered. Supposed extremely low prevalence of GAI patients in the general population and/or the existence of asymptomatic individuals with a questionable benefi t of the applied therapeutic intervention for them lead to doubts whether the inclusion of disease into the newborn screening programme is justifi ed well enough (Tab. 1, Fig. 3