Laboratory analysis of acylcarnitines, 2020 update: a technical standard of the American College of Medical Genetics and Genomics (ACMG)

被引:26
作者
Miller, Marcus J. [1 ]
Cusmano-Ozog, Kristina [2 ]
Oglesbee, Devin [3 ]
Young, Sarah [4 ]
机构
[1] Indiana Univ Sch Med, Dept Med & Mol Genet, Indianapolis, IN 46202 USA
[2] Stanford Univ, Med Ctr, Dept Pathol, Stanford, CA 94305 USA
[3] Mayo Clin, Lab Med & Pathol, Rochester, MN USA
[4] Duke Univ, Sch Med, Dept Pediat, Durham, NC USA
[5] Amer Coll Med Genet & Genom, Bethesda, MD USA
关键词
clinical genetic testing; fatty acid oxidation disorders; organic acidemias; acylcarnitine; tandem mass spectrometry; TANDEM MASS-SPECTROMETRY; DRIED BLOOD SPOT; FATTY-ACID; ESI-MS/MS; FREE CARNITINE; DEHYDROGENASE-DEFICIENCY; PEROXISOMAL BIOGENESIS; QUANTITATIVE-ANALYSIS; ORGANIC ACIDEMIAS; SCREENING METHOD;
D O I
10.1038/s41436-020-00990-1
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
Acylcarnitine analysis is a useful test for identifying patients with inborn errors of mitochondrial fatty acid beta-oxidation and certain organic acidemias. Plasma is routinely used in the diagnostic workup of symptomatic patients. Urine analysis of targeted acylcarnitine species may be helpful in the diagnosis of glutaric acidemia type I and other disorders in which polar acylcarnitine species accumulate. For newborn screening applications, dried blood spot acylcarnitine analysis can be performed as a multiplex assay with other analytes, including amino acids, succinylacetone, guanidinoacetate, creatine, and lysophosphatidylcholines. Tandem mass spectrometric methodology, established more than 30 years ago, remains a valid approach for acylcarnitine analysis. The method involves flow-injection analysis of esterified or underivatized acylcarnitines species and detection using a precursor-ion scan. Alternative methods utilize liquid chromatographic separation of isomeric and isobaric species and/or detection by selected reaction monitoring. These technical standards were developed as a resource for diagnostic laboratory practices in acylcarnitine analysis, interpretation, and reporting.
引用
收藏
页码:249 / 258
页数:10
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