Publications by authors named "Zhuwen Gong"

Background: Fanconi-Bickel syndrome (FBS) is a rare autosomal recessive disorder characterized by impaired glucose and galactose utilization as well as proximal renal tubular dysfunction.

Methods: Clinical, biochemical, genetic, treatment, and follow-up data for 11 pediatric patients with FBS were retrospectively analysed.

Results: Hepatomegaly (10/11), short stature (10/11) and hypophosphataemic rickets (7/11) were the most common initial symptoms.

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Article Synopsis
  • - The study focused on understanding the effects of the MMACHC c.482G > A mutation linked to CblC disease in 195 Chinese patients, analyzing their clinical features and outcomes over a median follow-up of nearly 4 years.
  • - It was found that 64.1% of patients were identified through newborn screening, with a significant portion remaining asymptomatic, while symptomatic cases showed a later onset of symptoms such as developmental delays and cognitive issues.
  • - In comparison, 159 symptomatic patients without the c.482G > A mutation exhibited different clinical manifestations, highlighting variations in disease presentation depending on the specific genetic mutation.
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Background: Methylmalonic acidemia (MMA), which results from defects in methylmalonyl-CoA mutase ( type) or its cofactor, is the most common inherited organic acid metabolic disease in China. This study aimed to investigate the phenotype and genotype of -type MMA in Chinese patients.

Methods: We recruited 365 patients with -type MMA; investigated their disease onset, newborn screening (NBS) status, biochemical metabolite levels, gene variations and prognosis; and explored the relationship between phenotype and genotype.

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  • X-linked adrenal hypoplasia congenita (AHC) is a rare disorder causing primary adrenal insufficiency and hypogonadotropic hypogonadism, with key symptoms like hyperpigmentation, vomiting, and developmental delays.
  • A study of 42 patients revealed that elevated adrenocorticotropic hormone (ACTH) and low cortisol levels were common lab findings, and most patients exhibited symptoms within the first year of life.
  • Genetic analysis showed two main defects, with the DAX1 defect being the most prevalent; treatment options included hormone therapies that showed varying degrees of effectiveness in improving testicular development and hormone levels.
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  • Phenylalanine hydroxylase (PAH) deficiency, commonly known as phenylketonuria (PKU), accounts for most cases of hyperphenylalaninemia (HPA) and around 5% of cases remain genetically unexplained.* -
  • A study using next-generation sequencing analyzed the PAH gene in 96 patients from 2013 to 2022, identifying 12 deep intronic variants that affect mRNA splicing, with most of these variants being novel and linked to different metabolic phenotypes.* -
  • The introduction of deep intronic variants improved the molecular diagnostic rate for HPA from 95.3% to 99.3%, highlighting the need to consider noncoding
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Background: Familial glucocorticoid deficiency (FGD) is a rare autosomal recessive disease characterized by glucocorticoid deficiency without mineralocorticoid deficiency. We report 3 Chinese patients with or mutations.

Case Reports: Patient 1 presented with hyperpigmentation.

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Objective: To investigate the clinical and genetic characteristics of infants with cobalamin (cbl) X type of methylmalonic acidemia (MMA).

Methods: The clinical data of 5 infants with cblX type of MMA diagnosed in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Shanghai Children's Hospital from the year 2016 to 2020 were collected. The levels of blood acylcarnitines were detected by tandem mass spectrometry, the levels of urinary organic acids were detected by gas-chromatography mass spectrometry, the pathogenic genes were detected by whole exon gene sequencing, and the effect of new pathogenic mutations on three-dimensional protein structure was predicted by bioinformatics analysis.

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Isovaleric acidemia (IVA) is an inborn error of leucine metabolism and different approaches have been applied to its prenatal diagnosis. However, systemic application of a biochemical strategy is rare. To evaluate its reliability and validity, we conducted a retrospective study of our experience with metabolite measurement together with genetic analysis in IVA prenatal diagnosis at a single center.

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The cblC type of combined methylmalonic acidemia and homocystinuria, an inherited disorder with variable phenotypes, is included in newborn screening (NBS) programs at multiple newborn screening centers in China. The present study aimed to investigate the long-term clinical benefits of screening individual. A national, retrospective multi-center study of infants with confirmed cblC defect identified by NBS between 2004 and 2020 was conducted.

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  • Glycogen storage disease (GSD) Type VI is a rare disorder linked to mutations in the PYGL gene and is characterized by symptoms like liver enlargement, short stature, and low blood sugar.
  • A study analyzed 56 GSD VI patients between 2000 and 2021, revealing improvements in growth and biochemical markers after treatment with uncooked cornstarch, although high uric acid levels often returned during adolescence.
  • The research identified 54 new genetic variants of PYGL, highlighting two common mutations predominantly found in patients from Southwest and South China, and emphasizing the need for ongoing uric acid monitoring in older patients.
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Background: To summarize the relationship between different MMUT gene mutations and the response to vitamin B12 in MMA.

Methods: This was a retrospective study of patients diagnosed with mut-type MMA. All patients with mut-type MMA were tested for responsiveness to vitamin B12.

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Purpose: To characterize the phenotypic and genotypic variations associated with Glutaric aciduria type 1 (GA1) in Chinese patients.

Methods: We analyzed the clinical, neuroradiological, biochemical, and genetic information from 101 GA1 patients in mainland China.

Results: 20 patients were diagnosed by newborn screening and the remaining 81 cases were identified following clinical intervention.

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Objective: Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) is a rare inherited metabolic disorder of fatty acid β-oxidation. The present study aimed to evaluate clinical and biochemical manifestations, and the mutation spectrum of this disorder in a large cohort of Chinese patients.

Methods: A total of 24 patients were enrolled, and blood acylcarnitine and urinary organic acid levels were measured by tandem mass spectrometry and gas chromatography-mass spectrometry (GC-MS), respectively.

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Background: Combined methylmalonic acidemia and homocystinuria, cobalamin C type (cblC defect) is the most common inborn error of cobalamin metabolism, and different approaches have been applied to its prenatal diagnosis. To evaluate the reliability of biochemical method for the prenatal diagnosis of cblC defect, we conducted a retrospective study of our 10-year experience at a single center.

Methods: 248 pregnancies whose probands were diagnosed as cblC defect were referred to our center for prenatal diagnosis from January 2010 to December 2019.

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Background: Methylmalonic acidemia is an inherited organic acid metabolic disease. It involves multiple physiological systems and has variable manifestations. The primary causative gene MMUT carries wide range of mutations, and one of them, c.

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Long continuous stretches of homozygosity (LCSH) are associated with risk of recessive disorders. Though LCSH can be detected by SNP microarrays, additional testing is necessary to clarify the clinical significance. This study is to assess the yield of additional exome sequencing (ES) after LCSH detection and inform the likelihood of eventual diagnosis.

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Background: Capture sequencing (CS) is widely applied to detect small genetic variations such as single nucleotide variants or indels. Algorithms based on depth comparison are becoming available for detecting copy number variation (CNV) from CS data. However, a systematic evaluation with a large sample size has not been conducted to evaluate the efficacy of CS-based CNV detection in clinical diagnosis.

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Background: Cleidocranial dysplasia (CCD) is a rare autosomal dominant disorder mainly characterized by hypoplastic or absent clavicles, delayed closure of the fontanelles, multiple dental abnormalities, and short stature. Runt-related transcription factor 2 () gene variants can cause CCD, but are not identified in all CCD patients.

Methods: In this study, we detected genetic variants in seven unrelated children with CCD by targeted high-throughput DNA sequencing or Sanger sequencing.

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Phenylketonuria (PKU), caused by phenylalanine hydroxylase (PAH) gene variants, is a common autosomal inherited metabolic disease. So far, 1111 PAH variants have been revealed. The residual activity of the PAH variants is the key determinant of the metabolic phenotype and BH responsiveness in PKU patients.

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Autism spectrum disorder (ASD) is a group of clinically and genetically heterogeneous neurodevelopmental disorders. Recent tremendous advances in the whole exome sequencing (WES) enable rapid identification of variants associated with ASD including single nucleotide variations (SNVs) and indels. To further explore genetic etiology of ASD in Chinese children with negative findings of copy number variants (CNVs), we applied WES in 80 simplex families with a single affected offspring with ASD or suspected ASD, and validated variations predicted to be damaging by Sanger sequencing.

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Article Synopsis
  • The study focuses on the genetic causes of short stature in 114 Chinese children with unexplained height issues, using advanced genetic testing methods like next-generation sequencing (NGS) and chromosomal microarray analysis (CMA).
  • Results showed that 36% of the patients had identifiable genetic causes, with higher diagnostic success in those exhibiting facial or skeletal abnormalities.
  • The findings suggest that NGS should be utilized as a primary diagnostic tool for short stature, offering a more streamlined approach to identifying genetic etiologies.
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Background: Developmental delay (DD) and intellectual disability (ID) are frequently associated with a broad spectrum of additional phenotypes. Chromosomal microarray analysis (CMA) has been recommended as a first-tier test for DD/ID in general, whereas the diagnostic yield differs significantly among DD/ID patients with different comorbid conditions.

Methods: To investigate the genotype-phenotype correlation, we examined the characteristics of identified pathogenic copy number variations (pCNVs) and compared the diagnostic yields among patient subgroups with different co-occurring conditions.

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Background: Hyperphenylalaninemia (HPA) is an inherited metabolic disorder that is caused by a deficiency of phenylalanine hydroxylase (PAH) or tetrahydrobiopterin. The prevalence of HPA varies widely around the world.

Methods: A spectrum of HPA candidate genes in 1020 Chinese HPA patients was reported.

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The diagnosis of intellectual disability/developmental delay (ID/DD) benefits from the clinical application of target/exome sequencing. The yield in Mendelian diseases varies from 25% to 68%. The aim of the present study was to identify the genetic causes of 33 ID/DD patients using target/exome sequencing.

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Background: Isolated methylmalonic acidemia is a rare autosomal recessive metabolic disorder mostly caused by mutations in the methylmalonyl coenzyme A mutase (MCM) gene (MUT). This study aimed to verify whether missense mutations in MUT in Chinese patients affect the stability and enzymatic activity of MCM.

Methods: Eight Chinese patients were identified with novel mutations.

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