EXTENDED NEONATAL SCREENING FOR THE IMMUNE SYSTEM CONGENITAL DEFECTS DETECTION: EXPERIENCE OF THE MOSCOW CENTER FOR NEONATAL SCREENING
Authors:   Morozov Children’s City Clinical Hospital, Moscow, Russia, Leontyeva M.E. , Kovtun E.I. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia, Zimin S.B. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia, Bronin G.O. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia, Shubina Yu.F. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia,   Pirogov Russian National Research Medical University, Moscow, Russia, Kekeeva T.N. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia, Vitkovskaya I.P. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia,   Central Scientific and Research Institute for Organization and Informatization of Healthcare, Moscow, Russia,   Pirogov Russian National Research Medical University, Moscow, Russia, Ryzhkova O.P. ,   Academician N.P. Bochkov Research Centre of Medical Genetics (RCMG) of the Ministry of Science and Higher Education of the Russian Federation, Moscow, Russia, Shilova N.V. ,   Academician N.P. Bochkov Research Centre of Medical Genetics (RCMG) of the Ministry of Science and Higher Education of the Russian Federation, Moscow, Russia, Marakhonov A.V. ,   Academician N.P. Bochkov Research Centre of Medical Genetics (RCMG) of the Ministry of Science and Higher Education of the Russian Federation, Moscow, Russia, Gorev V.V. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia, Rumyantsev A.G. ,   Pirogov Russian National Research Medical University, Moscow, Russia,   National Scientific and Practical Center for Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Moscow, Russia, Pampura A.N. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia,   Research and Clinical Institute of Pediatrics and Pediatric Surgery named after Academician Yuri Veltischev with the Pirogov Russian National Research Medical University, Moscow, Russia,   Russian Medical Academy for Continuous Professional Education, Moscow, Russia
Published: June 2024

Starting Jan., 2023 the extended neonatal screening (ENS) has been carried out in Russia that includes the determination of TREC/KREС markers, which in its turn allow suspecting severe combined immunodeficiency (SCID), phenotypical T-cell immunodeficiencies and X-linked agammaglobulinemia (XLA) prior to possible development of severe infectious complications. The purpose of the research was to evaluate the results of ENS for congenital immunodeficiency disorders (CIDs) in newborns in Moscow and to subsequently identify the most problematic issues in organizing of its implementation. Materials and methods used: the study was conducted in the Morozov Children's City Clinical Hospital (Moscow, Russia) among the 116,584 children born in Moscow in Jan. 01-Dec. 31, 2023 (this was the first year since the ENS introduction in Moscow) with a decrease in TREC/KREC below 100 copies per 105. Results: a total of 14 patients with CIDs were identified, of which 4 patients had a genetically confirmed form of SCID; 2 patients with immunophenotype of SCID; 3 patients with XLA; 2 patients with DiGeorge syndrome; single patient with a syndrome associated with a mutation in the PI4KA gene; and 2 patients with syndromic pathology without genetic confirmation. Thus, the frequency of detection of patients with the immunophenotype of SCID was a single case per 19,430 children, the frequency of patients with XLA was 1:38,861. 5 of 14 had already received hematopoietic stem cell transplantation, single patient was preparing for it at the time of the manuscript finalization. All of the patients receive regular immunoglobulin replacement therapy. Conclusion: the experience of an integrated approach to the provision of medical care based on neonatal screening in a municipal children's multidisciplinary hospital is presented; the results of the study helped identifying organizational shortcomings and determined the vector for its further development in order to improving of medical care provision to children with CIDs.