By Nancy Maddox, writer
“This is how naïve we were,” said Sherry Dilworth. “We had the whole family going to the hospital. We had a bag of bread; we were going to feed the ducks afterward.”
On that afternoon in 2009, Sherry and her husband were taking their third child, Avery, then just days old, for what they thought was routine follow-up for a mild case of newborn jaundice and fluctuating blood sugar levels. Like so many parents of children with inherited disorders, Sherry said, “I didn’t give a thought to newborn screening until it affected me.”
Sitting in the hospital waiting room, Sherry recalled, “I was laughing at a story my husband was telling when I heard the receptionist, speaking into the phone, say strange things like genetic testing and biochemical markers. The smile dropped from my face and I said to my husband, ‘I don’t think we know why we’re here.’”
Unbeknownst to Sherry at the time, both she and her husband are carriers for a rare disorder called malonyl-coenzyme A decarboxylase deficiency or malonic aciduria for short. As confirmatory tests would show, Avery had inherited the defective gene from both parents.
Malonic aciduria is so rare that fewer than 30 cases have been documented worldwide. Untreated, it can be fatal. More commonly, it is associated with seizures, mental impairment, developmental delays and a heart condition called cardiomyopathy. Yet, because so little is known about the disorder—and Avery is among the first children to be diagnosed and treated from birth—physicians don’t even know how long affected youngsters will live.
When Sherry learned the full implications of the diagnosis, she said, “I could not fathom that we were talking about my perfectly happy and healthy looking baby girl and life expectancy in the same sentence… I’m thinking, Who are we to have this happen to us? But why not us?”
Despite the devastating news, Sherry considers her family lucky. The condition Avery has, she said, “all of our kids had a chance of inheriting.” Moreover, the state of Utah, where the family lived until recently, did not begin screening infants for malonic aciduria until 2006, just three years before Avery’s birth. “So had our other kids had it, they would have been missed.”
The disorder—which renders the body unable to convert certain fats to energy—is treated with a low-fat diet, regular feeding (as fasting can trigger a metabolic crisis) and daily doses of L-carnitine (a medicine that helps break down fats). Sherry said, “We have some minor issues [with Avery’s health], but what they told us could have happened was horrific. It is so amazing to me that this one test has completely changed her life. It would be so different right now.”
Today, Avery is four years old. She’s crazy about peaches, likes to push her baby dolls around in a stroller and is eager to start preschool this year. Sherry says, “She’s been wearing her backpack all week.”
In her young life, Avery has experienced minor problems with muscle tone and minor developmental delays—walking at 18 months instead of the usual 12, for example—but is otherwise a “normal” child. “If you didn’t know, you would see Avery and you wouldn’t have any clue that she has any health issues at all,” says her mom. “She climbs, she plays, she gets into trouble.”
In fact, Sherry says Avery has been fun for the whole family:
“Our older daughter, Neva, has autism and she prefers to be alone. Avery is super social. She flirts with everyone. She’ll just randomly talk to strangers and smile at them and everyone will say, ‘She’s so cute.’ . . . . She likes to dress up like a princess and she likes to wear those outfits to the store. If I’m in line, she’ll chat with the person behind us, she’ll chat with the person in front of us, and she’ll chat with the cashier. Neva adores Avery. She doesn’t like to play with other people, but she lets Avery go into her room all the time. Avery is like the thing that connects us all to each other. She’s like that for everyone; everyone has a special connection to her… There’s something about her that draws people to her. It’s infectious.”
Sherry is well aware how critical it was for Avery to have an early diagnosis. “If you took out newborn screening, we would have a completely different story,” she said. “The fact that we don’t have a tragic story, that’s the point. This is why newborn screening is so important.”
The state of Utah screens about 52,500 newborns each year for 38 disorders. About 350 Utah newborns are identified each year with a congenital disorder initially detected through bloodspot screening.
Thank you for sharing Avery’s story. I also have a child diagnosed with Malonic Aciduria. We have three children, but only our eldest son Isaac has the rare condition. He was also diagnosed as a result of New born screening in 2006, Melbourne, Australia.
Isaac has significant developmental delay, he didn’t crawl until he was 17 months of age,
or walk until he was 2 years of age. He has attended regular speech therapy since he was 2 years old, and begun an intense early Intervention program by 3 years of age.
He has taken L- Carnitine twice a day since he was diagnosed. Thankfully at this stage he has no sign of Cardiomyopathy.
Isaac was also diagnosed with Autism at three years of age.
When Isaac gets sick, be it the common cold or virus, he often ends up in hospital to be put on IV fluids, to prevent complications due to fasting, as he refuses to eat when he’s unwell.
Isaac is now 7 years of age, he is a delightful young boy. He attends a special school 5 days a week, and attends speech therapy weekly. He loves his little sister and brother, and he’s passionate about Mario brothers! We’re so thankful for every day we have with him.
Hi Sherry
My Wife & I know exactly what you are going through My son Jason was the second child in the world to be Diagnossed with malonyl-coenzyme A decarboxylase deficiency which was named on the Good Friday Appeal In Melbourne 1974 Unlike the other child Jason was the first one to be put on a low fat hi carborate diet. he was was diagnosed at about 10mths old when i found him in a comma in his bed. Like your child Jason didnt start walking until 18mths old has development delay and learning diffulties and a lot other problems. Jason is now 30 years old he has a girlfiend and a steady job and yes like your child to look at you would think nothing wrong. he has short term memory loss he cannot read or wright properly and a few other problems. But I wouldnt change him for the world. You could ask for a more kind & caring Person yes he still has his problems & Frustations and he tries his Best Unlike children diagnosed today that have some sort help We had to do it and learn with our doctors our selves Jason has spent a lot months in Hospital having test But he is doing alright If we can help in any way please cantact us via e-mail grumpy79@dodo.com.au Ken
Hi Sherry! So thankful you have shared your story and thankful for a friend that led me to your story. I too have a daughter with malonic aciduria. She was diagnosed before ever leaving the hospital when she was born, however she was in NICU for many days during her diagnosis. My Bronwen is 4. So far she has not had any developmental delays. If you would like to you may contact me via e-mail at trishinark@yahoo.com I’d love to hear more about how you all have dealt with proper diet and care.
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