Publications by authors named "Benedetta Greco"

Acid sphingomyelinase deficiency (ASMD) is a rare, progressive lysosomal storage disorder resulting from a deficiency in acid sphingomyelinase, leading to sphingomyelin accumulation and multi-organ damage. ASMD presents a broad phenotypic spectrum with a continuum of severity, making it challenging to predict the phenotype in very young children and differentiate between acute and chronic neurovisceral disease. No disease-specific treatments existed for ASMD.

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Liver transplantation (LTx) is increasingly used in Urea Cycle Defects (UCDs) to prevent recurrent hyperammonemia and related neurological irreversible injury. Among UCDs, argininosuccinate lyase deficiency (ASLD) has a more complex phenotype than other UCDs, with long-term neurocognitive deficits. Therefore, the role of LTx in ASLD is still debated.

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Article Synopsis
  • Cobalamin C (Cbl-C) defect leads to serious health issues like methylmalonic acidemia and cognitive impairment, but treatment with hydroxocobalamin (OH-Cbl) doses remains uncertain.
  • * A study compared high-dose OH-Cbl treatment in newborn screening (NBS)-diagnosed patients to low-dose treatment in other groups, showing that the high-dose group had significantly better metabolic and neurodevelopmental outcomes.
  • * Results indicated that while high-dose treatment improved overall health markers and cognitive performance, it did not affect the incidence of maculopathy, signaling a need for clearer dosing guidelines in Cbl-C treatment.*
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Introduction: To evaluate and describe the diagnostic process, medical, nutritional, and surgical approach, and neurological outcome, we report data from a large Italian cohort of patients with congenital hyperinsulinism (CHI).

Methods: We retrospectively analyzed 154 CHI patients admitted to Ospedale Pediatrico Bambino Gesù from 1985 to 2022.

Results: Hypoglycemia occurred within the first year of life in 85.

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Receiving information in the case of a positive or false-positive expanded newborn screening (ENBS) result for metabolic diseases is a stressful event. The availability of psychological support to families is crucial across the different communication steps and is recommended by different guidelines and position papers. However, more information is needed about the availability of psychological resources in the ENBS process.

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Organic acidurias (OAs), urea-cycle disorders (UCDs), and maple syrup urine disease (MSUD) belong to the category of intoxication-type inborn errors of metabolism (IT-IEM). Liver transplantation (LTx) is increasingly utilized in IT-IEM. However, its impact has been mainly focused on clinical outcome measures and rarely on health-related quality of life (HRQoL).

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Article Synopsis
  • Liver and kidney transplantation in patients with methylmalonic aciduria shows potential for improving neurological outcomes, as assessed through clinical evaluations and biomarker measurements before and after the procedure.
  • Significant improvements were noted in primary and secondary biomarkers in plasma, while mitochondrial dysfunction markers decreased in cerebrospinal fluid (CSF), suggesting a positive shift in metabolic status post-transplant.
  • Neurocognitive assessments indicated improved developmental scores and brain health post-transplant, although some patients experienced reversible neurological issues that required differentiation to determine their cause; early transplantation is recommended due to the risks associated with long-term complications.
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Background: Hyperinsulinemic hypoglycemia (HI) is the most frequent cause of recurrent hypoglycemia in children. Despite diagnostic and therapeutic advances, it remains an important cause of morbidity, leading to neurological complications, such as psychomotor retardation and epilepsy. Patients with diffuse drug-unresponsive HI manifest neurological impairment and neurobehavioral problems, even though surgically treated with a near-total pancreatectomy.

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