Ms. Rashed et al., ELECTROSPRAY TANDEM MASS-SPECTROMETRY IN THE DIAGNOSIS OF ORGANIC ACIDEMIAS, Rapid communications in mass spectrometry, 8(1), 1994, pp. 129-133
A novel procedure based on electrospray tandem mass spectrometry (ESI-
MS/MS) has been used in the diagnosis of organic acidemias. The method
is based on the determination of acylcarnitine profiles from blood sp
ots collected on Guthrie cards. The acylcarnitines are extracted with
methanol, derivatized to their butyl esters and analyzed by ESI-MS/MS.
Precursor-ion scanning of the common fragment at m/z 85 of the butyl
esters yields highly diagnostic acylcarnitine profiles. Analysis time
is one minute per sample and is fully automated. Examples are given of
normal profiles, of profiles from two patients with fatty acid oxidat
ion defects, and of a case of propionic acidemia. The technique is sim
ple, rapid and specific, and shows potential for routine application i
n neonatal screening of organic acidemias.