{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T19:01:08Z","timestamp":1767898868109,"version":"3.49.0"},"reference-count":67,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T00:00:00Z","timestamp":1730332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto Nacional de Pediatr\u00eda, Secretar\u00eda de Salud"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Biochemical phenotyping has been the milestone for diagnosing and managing patients affected by inborn errors of intermediary metabolism (IEiM); however, identifying the genotype responsible for these monogenic disorders greatly contributes to achieving these goals. Herein, whole-exome sequencing (WES) was used to determine the genotypes of 95 unrelated Mexican pediatric patients suspected of having IEiM. They were classified into those bearing specific biochemical abnormalities (Group 1), and those presenting unspecific biochemical profiles (Group 2). The overall concordance between the initial biochemical diagnosis and final genotypic diagnoses was 72.6% (N = 69\/95 patients), with the highest concordance achieved in Group 1 (91.3%, N = 63\/69), whereas the concordance was limited in Group 2 (23.07%). This finding suggests that previous biochemical phenotyping correlated with the high WES diagnostic success. Concordance was high for urea cycle disorders (94.1%) and organic acid disorders (77.4%). The identified mutational spectrum comprised 83 IEiM-relevant variants (pathogenic, likely pathogenic, and variants of uncertain significance or VUS), including three novel ones, distributed among 29 different genes responsible for amino acid, organic acid, urea cycle, carbohydrate, and lipid disorders. Inconclusive WES results (7.3%, N = 7\/95) relied on monoallelic pathogenic genotypes or those involving two VUS for autosomal-recessive IEiMs. A second monogenic disease was observed in 10.5% (N = 10\/95) of the patients. According to the WES results, modifications in treatment had to be made in 33.6% (N = 32\/95) of patients, mainly attributed to the presence of a second monogenic disease, or to an actionable trait. This study includes the largest cohort of Mexican patients to date with biochemically suspected IEiM who were genetically diagnosed through WES, underscoring its importance in medical management.<\/jats:p>","DOI":"10.3390\/ijms252111722","type":"journal-article","created":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T09:57:36Z","timestamp":1730368656000},"page":"11722","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Concordance Between Biochemical and Molecular Diagnosis Obtained by WES in Mexican Patients with Inborn Errors of Intermediary Metabolism: Utility for Therapeutic Management"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8230-4611","authenticated-orcid":false,"given":"Marcela","family":"Vela-Amieva","sequence":"first","affiliation":[{"name":"Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatr\u00eda, Secretar\u00eda de Salud, Mexico City C.P. 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0592-8214","authenticated-orcid":false,"given":"Miguel Angel","family":"Alc\u00e1ntara-Ortigoza","sequence":"additional","affiliation":[{"name":"Laboratorio de Biolog\u00eda Molecular, Instituto Nacional de Pediatr\u00eda, Secretar\u00eda de Salud, Mexico City C.P. 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7096-0969","authenticated-orcid":false,"given":"Ariadna","family":"Gonz\u00e1lez-del Angel","sequence":"additional","affiliation":[{"name":"Laboratorio de Biolog\u00eda Molecular, Instituto Nacional de Pediatr\u00eda, Secretar\u00eda de Salud, Mexico City C.P. 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4153-6966","authenticated-orcid":false,"given":"Liliana","family":"Fern\u00e1ndez-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Laboratorio de Biolog\u00eda Molecular, Instituto Nacional de Pediatr\u00eda, Secretar\u00eda de Salud, Mexico City C.P. 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3123-8305","authenticated-orcid":false,"given":"Miriam Erandi","family":"Reyna-Fabi\u00e1n","sequence":"additional","affiliation":[{"name":"Laboratorio de Biolog\u00eda Molecular, Instituto Nacional de Pediatr\u00eda, Secretar\u00eda de Salud, Mexico City C.P. 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernardette","family":"Estand\u00eda-Ortega","sequence":"additional","affiliation":[{"name":"Laboratorio de Biolog\u00eda Molecular, Instituto Nacional de Pediatr\u00eda, Secretar\u00eda de Salud, Mexico City C.P. 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6874-8662","authenticated-orcid":false,"given":"Sara","family":"Guill\u00e9n-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatr\u00eda, Secretar\u00eda de Salud, Mexico City C.P. 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0058-8273","authenticated-orcid":false,"given":"Lizbeth","family":"L\u00f3pez-Mej\u00eda","sequence":"additional","affiliation":[{"name":"Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatr\u00eda, Secretar\u00eda de Salud, Mexico City C.P. 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3691-3659","authenticated-orcid":false,"given":"Leticia","family":"Belmont-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatr\u00eda, Secretar\u00eda de Salud, Mexico City C.P. 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9229-2351","authenticated-orcid":false,"given":"Rosa Itzel","family":"Carrillo-Nieto","sequence":"additional","affiliation":[{"name":"Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatr\u00eda, Secretar\u00eda de Salud, Mexico City C.P. 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8693-8531","authenticated-orcid":false,"given":"Isabel","family":"Ibarra-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Unidad de Gen\u00e9tica de la Nutrici\u00f3n, Instituto de Investigaciones Biom\u00e9dicas, UNAM, Mexico City C.P. 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3509-1208","authenticated-orcid":false,"given":"Seung-Woo","family":"Ryu","sequence":"additional","affiliation":[{"name":"3billion, Inc., Seoul 03161, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4736-0412","authenticated-orcid":false,"given":"Hane","family":"Lee","sequence":"additional","affiliation":[{"name":"3billion, Inc., Seoul 03161, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7468-3420","authenticated-orcid":false,"given":"Cynthia","family":"Fern\u00e1ndez-Lainez","sequence":"additional","affiliation":[{"name":"Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatr\u00eda, Secretar\u00eda de Salud, Mexico City C.P. 04530, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1016\/j.ajhg.2023.06.009","article-title":"Beyond the exome: What\u2019s next in diagnostic testing for Mendelian conditions","volume":"110","author":"Wojcik","year":"2023","journal-title":"Am. 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