Phenylketonuria is a disease.

Written by Yan Xin Liang
Pediatrics
Updated on September 02, 2024
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Phenylketonuria is an autosomal recessive genetic disorder resulting from mutations in the phenylalanine hydroxylase gene, leading to reduced enzyme activity and the accumulation of phenylalanine and its metabolic products in the body, thereby causing this disease. Phenylketonuria is the most common congenital amino acid metabolic disorder, clinically characterized by intellectual developmental delays, light skin and hair pigmentation, and a mouse-like urine odor. The incidence of the disease varies by race and region, with an incidence rate in China of about 1 in 11,000. Phenylalanine is an essential amino acid for the human body, but due to reduced activity of phenylalanine hydroxylase, phenylalanine cannot be converted into tyrosine, leading to extremely high concentrations of phenylalanine in the blood, cerebrospinal fluid, and tissues. Abnormal metabolism produces a large amount of phenylpyruvic acid, phenylacetic acid, phenyllactic acid, and p-hydroxyphenylacetic acid, along with high concentrations of phenylalanine and its metabolic products, causing brain damage and corresponding symptoms.

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Written by Yan Xin Liang
Pediatrics
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How is phenylketonuria diagnosed?

How is phenylketonuria diagnosed? Firstly, we start with screening, which is usually done when the newborn is 3 to 7 days old by heel prick to collect peripheral blood, which is then dropped onto specialized filter paper for the determination of phenylalanine concentration. If the concentration of phenylalanine is above the cutoff value, further determination of phenylalanine concentration is conducted. The normal concentration is less than 120 umol/L. If the concentration of phenylalanine is greater than 1200 umol/L, it suggests severe phenylketonuria. Moderate levels are above 360 umol/L, and mild levels are above 120 umol/L but less than 360 umol/L. Furthermore, diagnosis can be confirmed through DNA analysis, currently available tests include screening for mutations in the phenylalanine hydroxylase gene.

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Written by Yan Xin Liang
Pediatrics
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Phenylketonuria lacks what enzyme?

Phenylketonuria is an autosomal recessive genetic disorder primarily caused by mutations in the phenylalanine hydroxylase gene. This leads to reduced activity of phenylalanine hydroxylase, accumulation of phenylalanine and its metabolites in the body, and the onset of the disease. Phenylketonuria is the most common congenital amino acid metabolism disorder. Clinically, it is mainly characterized by intellectual developmental delays, light skin and hair pigmentation, and a mousey urine odor. The incidence of this disease varies by ethnicity and region. In China, the incidence is approximately 1 in 11,000.

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Written by Yao Li Qin
Pediatrics
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Phenylketonuria should be treated in which department?

Phenylketonuria is a common autosomal recessive genetic disorder due to a deficiency in the enzymes involved in the metabolic pathway of phenylalanine. It is a genetic metabolic disease. After the birth of a child, newborn screening is conducted for this disease. If a child is diagnosed with phenylketonuria or suspected of having the condition, it is common to visit a pediatric neurology department at a children's hospital. Phenylketonuria mainly causes varying degrees of intellectual disability, and some children may even experience epileptic seizures. Additionally, about 90% of affected children gradually develop lighter skin and hair, reduced iris pigmentation, dry skin, eczema, and a distinctive mouse-like urine odor, which is due to the excretion of phenylacetic acid in urine and sweat. It is a challenging genetic metabolic disorder to treat, requiring special dietary management. It is advisable to bring the child to the pediatric neurology department. Some hospitals may have a specialized department for genetic metabolic diseases. If such a department is available, it is recommended to consult there; otherwise, pediatric neurology is the appropriate alternative.

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Written by Yan Xin Liang
Pediatrics
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Is the incidence of phenylketonuria high?

Phenylketonuria is an autosomal recessive hereditary disease and is the most common congenital amino acid metabolic disorder. The main clinical manifestations include distinctive features such as intellectual disability, light skin and hair pigmentation, and a mouse-like urine odor, which is named after the large amounts of phenylketone acid metabolites excreted in the urine. The incidence of this disease varies by race and region, and the overall incidence in China is approximately 1:11,000, meaning one in eleven thousand. The incidence is higher in the northern population than in the southern population, though it is not particularly high.

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Written by Yan Xin Liang
Pediatrics
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Phenylketonuria smells like mouse urine.

Phenylketonuria is a common amino acid metabolic disorder primarily caused by a deficiency of phenylalanine hydroxylase. This deficiency prevents phenylalanine from being converted to tyrosine, leading to the accumulation of phenylalanine and ketone bodies, which are then excreted in large amounts in the urine. This disease is relatively common among genetic amino acid metabolic disorders and is inherited as an autosomal recessive trait. Additionally, due to the lack of phenylalanine hydroxylase, phenylalanine is metabolized through another pathway, resulting in increased production of phenyllactic acid and phenylacetic acid, which are excreted through sweat and urine, giving off a mouse-like urine odor.