Published online March 30, 2009
PEDIATRICS Vol. 123 No. 4 April 2009, pp. 1191-1207 (doi:10.1542/peds.2008-0635)
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REVIEW ARTICLE

Lysosomal Storage Disorders in the Newborn

Orna Staretz-Chacham, MDa, Tess C. Lang, BSb, Mary E. LaMarca, BAb, Donna Krasnewich, MD, PhDa and Ellen Sidransky, MDb

a Office of the Clinical Director
b Section on Molecular Neurogenetics, Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland

Lysosomal storage disorders are rare inborn errors of metabolism, with a combined incidence of 1 in 1500 to 7000 live births. These relatively rare disorders are seldom considered when evaluating a sick newborn. A significant number of the >50 different lysosomal storage disorders, however, do manifest in the neonatal period and should be part of the differential diagnosis of several perinatal phenotypes. We review the earliest clinical features, diagnostic tests, and treatment options for lysosomal storage disorders that can present in the newborn. Although many of the lysosomal storage disorders are characterized by a range in phenotypes, the focus of this review is on the specific symptoms and clinical findings that present in the perinatal period, including neurologic, respiratory, endocrine, and cardiovascular manifestations, dysmorphic features, hepatosplenomegaly, skin or ocular involvement, and hydrops fetalis/congenital ascites. A greater awareness of these features may help to reduce misdiagnosis and promote the early detection of lysosomal storage disorders. Implementing therapy at the earliest stage possible is crucial for several of the lysosomal storage disorders; hence, an early appreciation of these disorders by physicians who treat newborns is essential.

Key Words: lysosomal storage disorders • neonatal • hydrops • enzyme deficiency

Abbreviations: LSD—lysosomal storage disorder • NIHF—nonimmune hydrops fetalis • ERT—enzyme-replacement therapy • MPS—mucopolysaccharidosis • ISSD—infantile sialic acid storage disease • CNS—central nervous system • HCT—hematopoietic stem cell transplantation

Accepted Aug 14, 2008.


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