Biochemical Genetics

We care for children and adults with known or suspected biochemical genetic disorders, which can also be called metabolic disorders or inborn errors of metabolism. Our multidisciplinary team of experts from different specialties provide treatment, disease management, support and resources to improve the quality of life for our patients. We work closely with researchers in our Genetics Lab.

Chemical reactions are responsible for breaking down nutrients and making energy in the body, such as metabolism. These reactions may also change 1 chemical to a different chemical that the body needs. Biochemical genetic disorders occur when there is a change in a gene that leads to a problem with 1 of the chemical reactions that takes place in cells in the body. This can result in a person experiencing several different symptoms.

Early diagnosis and treatment for biochemical genetic diseases can improve a person’s quality of life. The Washington State Department of Health screens newborns for some of these diseases. We work with them to provide any follow-up genetic testing and care that newborns may need.

Our program is part of the American Board of Medical Genetics–certified training program at the University of Washington. In addition, the National Organization for Rare Disorders (NORD) has designated Seattle Children’s a Rare Disease Center of Excellence. We are the only pediatric hospital in the Pacific Northwest region with this designation.

Conditions We Treat

There are hundreds of genetic disorders related to metabolism. Six kinds are shown below. We treat these and other conditions.

  • Individuals with these disorders cannot use fats for energy. This can lead to low blood sugar, muscle weakness and heart problems. Medicines and special diets can treat many of these disorders. Examples are medium-chain acyl-coenzyme A dehydrogenase (MCAD) deficiency and very long–chain acyl-coenzyme A dehydrogenase (VLCAD) deficiency.

  • Many building blocks of the body, such as proteins, fats and other molecules, need to have sugars attached to them to work properly. Individuals with congenital disorders of glycosylation (CDG) cannot attach these sugars or sugar chains properly. Children or adults with CDG may have problems with growth and learning, and the disorder may affect many parts of the body, including the brain, nerves, muscles, liver and immune system. Examples of CDGs include PMM2-CDG, ALG1-CDG, PIGT-CDG and MPI-CDG. Additionally, individuals may also have NGLY1-CDDG, a disorder where the body has trouble taking off sugar chains from some proteins.

  • These disorders are due to a buildup of complex sugars within small sections inside cells. These sections are called lysosomes. The buildup makes the cells swell and become damaged so they do not work normally. All lysosomal storage disorders (LSDs) affect different body systems and cause different symptoms. Some LSDs can be treated. Examples of LSDs are Gaucher disease, Pompe disease, all types of mucopolysaccharidosis (MPS), Fabry disease and Tay-Sachs disease.

  • These disorders affect how the body makes energy. They can involve many body systems. Most often they involve the heart, brain and muscles. Examples are mitochondrial encephalomyopathy lactic acidosis and strokelike episode (MELAS), Alpers disease, Barth syndrome, Leigh syndrome and respiratory chain complex deficiency.

  • Children with these disorders cannot properly use protein for energy. This can cause toxic acids to build up in their bodies. They may then have problems with growth, learning and overall health. Medicines and special diets can treat many of these disorders. Examples of organic acid disorders are propionic acidemia (PA), methylmalonic acidemia (MMA) and glutaric acidemia types I and II.

  • Children with these disorders cannot use protein properly for energy. This can cause toxic by-products to build up in their bodies. The buildup can lead to problems with growth, learning and overall health. Medicines and special diets can treat many of these disorders. Examples of urea cycle disorders are ornithine transcarbamylase (OTC) deficiency, arginase deficiency and citrullinemia.

  • Children with Wilson disease cannot get rid of extra copper they receive from their diet but do not need. Most children's bodies filter out this extra copper. But for children with Wilson disease, the copper builds up and can damage their liver, brain and other organs. Medicines and diet changes can treat Wilson disease if it is diagnosed early.

Services We Provide

  • Many children born with metabolic diseases need care and treatment throughout their lives. This helps them to do the best physically and mentally and have the best possible quality of life.

    We provide complete diagnostic evaluation and comprehensive care. This includes testing for newborns with abnormal Washington state newborn screenings, complete nutritional assessments and long-term metabolic management along with dietary treatments. Genetic counseling is available for children and adults with suspected or diagnosed inborn errors of metabolism. Social work support to connect patients to resources within the hospital and community and to help patients adjust to diagnoses is also available.

    At Seattle Children's we provide a long-term "medical home" for your child — a place that manages all their care to help them get the most complete care they can. We work closely with other doctors in the clinic and hospital if your child gets sick. We also help other doctors in the Northwest to provide proper care for your child.

  • Some metabolic diseases happen because a child has an enzyme that is not normal. This causes sugars and proteins to build up in the body. In enzyme replacement therapy (ERT), we give your child the enzyme they need through an intravenous (IV) line. This process is called infusion. ERT treats the symptoms of the disease but does not cure the disease. It is used for some lysosomal storage disorders — Gaucher disease, Fabry disease, MPS I, MPS VI and glycogen storage disease type II (or Pompe disease).

Participate in Research

We invite children and their families to participate in our studies. By participating in a research study, your child will have access to some of the latest treatments and therapies, and will receive support and care from our research team. Participation is voluntary. Your child will receive the same quality care whether or not you participate.

Telemedicine at Seattle Children’s

You may be offered a telehealth (virtual) appointment. Learn more.

Paying for Care

Learn about paying for care at Seattle Children’s, including insurance coverage, billing and financial assistance.

Access Additional Resources

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