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Repeat Newborn Screen Result
Normal repeat newborn screening result.
If the first screen showed a markedly elevated level of C4 a normal
second screen result is reassuring BUT this does not rule out
SCADD. Therefore the metabolic physician may want to continue
treating the baby as though he/she has SCADD while awaiting the
results of more definitive tests.
If the first screen was only mildly elevated however, the newborn
screening increase was probably transient (false positive).
Once the metabolic team has confirmed that the infant does not
have SCADD, it is essential to reassure the family that their
baby is well and that they should treat their baby as entirely
normal. Many people can be traumatized by a false positive result
and counseling may be appropriate. If the metabolic physician
remains concerned, however, then he/she will discuss this further
with you and may decide to continue with frequent feeds and early
intervention if the baby becomes sick. It is important to remember,
however, that this does not mean that the baby has SCADD but only
that the metabolic doctor is taking an extra cautious approach
until definitive results are available to keep the baby safe and
well.
Abnormal repeat newborn screen result.
An elevated C4 on the second sample is very suspicious of SCADD
and further evaluation by the metabolic doctor is definitely required.
The baby must be treated as though he/she has SCADD while definitive
testing is carried out.
See C4 markedly elevated, probable SCADD
discussions in first newborn screening result section. 
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