How is phenylketonuria cured?

Written by Yan Xin Liang
Pediatrics
Updated on September 20, 2024
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Phenylketonuria is an autosomal recessive genetic disease, primarily due to a mutation in the phenylalanine hydroxylase gene which leads to reduced enzymatic activity, causing the accumulation of phenylalanine and its metabolites in the body, thereby leading to this disease. The main manifestations include developmental intellectual disabilities, light skin and hair pigmentation, and a musty urine odor. Once diagnosed, immediate treatment is necessary, mainly using a low-phenylalanine formula milk. Generally, when orally administering low-phenylalanine formula milk, it is essential to monitor the phenylalanine levels in the blood. Since each patient has a different tolerance level for phenylalanine, periodic determination of blood phenylalanine concentration is required in the dietary treatment. Such patients can only be treated long-term in this way; it is not curable nor can it be completely eradicated; treatment can only alleviate the symptoms and involves long-term administration of a low-phenylalanine diet.

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Written by Yan Xin Liang
Pediatrics
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Do children with mild phenylketonuria need treatment?

Phenylketonuria is a common amino acid metabolic disease, primarily due to the deficiency of phenylalanine hydroxylase, preventing phenylalanine from being converted into tyrosine. This leads to the accumulation of phenylalanine and its keto acids in the body, which are then excreted in large amounts in the urine. It is a relatively common genetic amino acid metabolic disorder and is inherited as an autosomal recessive trait. Even in cases of mild symptoms, treatment is still required. The main treatment is a low-phenylalanine diet, which involves dietary control, as phenylalanine is an essential amino acid for protein synthesis. Special phenylalanine-formula milk powder is fed to infants, and at this stage, it is appropriate to add some complementary foods such as starchy vegetables and fruits, focusing on low-protein foods. The goal of dietary treatment is to maintain an appropriate concentration of phenylalanine in the blood.

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Written by Yan Xin Liang
Pediatrics
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Phenylketonuria Test Methods

The examination methods for phenylketonuria primarily include newborn screenings usually performed three to seven days after birth by drawing a blood sample from the heel and placing drops on specialized blood collection filter paper. Once dried, the sample is sent to a screening laboratory to determine the concentration of phenylalanine. If the phenylalanine concentration exceeds the cutoff value, further examinations and confirmatory tests are necessary, with the confirmatory test involving the measurement of phenylalanine concentration. Another method involves the analysis of urinary pterin profile, mainly used to differentiate dihydrobiopterin reductase deficiency. Additionally, gene analysis can be applied to detect mutations in genes such as phenylalanine hydroxylase, aiding in genetic diagnoses and prenatal diagnoses.

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Written by Yan Xin Liang
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Phenylketonuria is what type of inheritance?

Phenylketonuria is an autosomal recessive genetic disorder and is the most common congenital amino acid metabolism disorder. The main clinical features include intellectual disability, pale skin and hair pigmentation, and a mouse-like urine smell. This condition is named after the high levels of phenylketonic acid metabolites excreted in the urine of affected patients. Phenylketonuria is an autosomal recessive genetic disease, and its primary pathological mechanism is due to the lack of phenylalanine hydroxylase, which fails to convert phenylalanine into tyrosine, leading to increased concentrations of phenylalanine in the blood, cerebrospinal fluid, and various tissues. Because the main metabolic pathway is blocked, secondary metabolic pathways are enhanced, leading to the deamination of phenylalanine and the production of large amounts of phenylketonic acid. Through oxidation, this produces byproducts such as phenylacetic acid, phenyllactic acid, and para-hydroxyphenylketonic acid, thereby resulting in a series of clinical symptoms.

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Written by Zeng Hai Jiang
Pediatrics
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Can phenylketonuria be breastfed?

Once a child with phenylketonuria is diagnosed, natural diets should be ceased and a low-phenylalanine diet treatment should be initiated. Treatment with a low-phenylalanine formula should continue at least until the age of 12. Breast milk is the ideal natural food for infants; therefore, although breastfeeding should be temporarily halted after diagnosis, it should not be completely stopped so that it can be promptly reintroduced once blood phenylalanine levels are controlled. When blood phenylalanine levels are controlled to an ideal concentration, gradually reintroduce small amounts of natural diet, preferably starting with breast milk, as it contains only one-third the phenylalanine content of cow's milk.

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Written by Yan Xin Liang
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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.