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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Is phenylketonuria characterized only by pale facial skin?

Phenylketonuria is a common amino acid metabolic disorder. It is primarily due to the deficiency of phenylalanine hydroxylase, which prevents the conversion of phenylalanine to tyrosine, leading to a series of clinical symptoms. These can manifest as intellectual disability, neuropsychiatric symptoms, eczema, skin scratching, pigment loss, and a musty odor. The skin whiteness mentioned is not merely facial pallor; it affects the entire skin because the benefits of tyrosine are reduced, leading to decreased melanin synthesis. Consequently, the hair of affected children can also be lighter and tend to be brown.

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Written by Yan Xin Liang
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What can be eaten with phenylketonuria?

Phenylketonuria is primarily due to a deficiency of phenylalanine hydroxylase in the body, which prevents the conversion of phenylalanine to tyrosine. Due to the blockage of the metabolic pathway, secondary metabolic pathways are enhanced, leading to the deamination of phenylalanine and the production of large amounts of phenylpyruvic acid. Through oxidation, by-products such as phenylacetic acid, phenyllactic acid, and para-hydroxyphenylpyruvic acid are formed. The treatment mainly involves the use of low-phenylalanine formula milk. When the concentration in the blood reaches the desired level, natural foods can be gradually added in small amounts. Breast milk is the preferred choice as it contains only one-third of the phenylalanine content of cow's milk. For older infants and children, cow's milk, porridge, noodles, and eggs can be added. The principle for introducing foods should be based on low protein and low phenylalanine content, adjusted according to the phenylalanine concentration in the blood. Both too high and too low levels of phenylalanine can affect growth and development.

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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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Can phenylketonuria be prevented?

Phenylketonuria belongs to a recessive hereditary metabolic disease; how can we take preventive measures? First, we must avoid consanguineous marriages. Second, we need to conduct newborn screening to achieve early diagnosis, early detection, and early treatment. Third, for pregnant women with a family history of this disease, it is mandatory to use DNA analysis or methods like amniotic fluid testing for prenatal diagnosis of their fetuses. Prevention is better than cure. By taking preventive measures early, the chances of complications occurring are greatly reduced. If a baby shows symptoms of newborn phenylketonuria, parents should not take it lightly and should actively cooperate with the treatment.

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Written by Zeng Hai Jiang
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What foods should children with phenylketonuria eat?

Phenylketonuria is a common amino acid metabolic disorder, an autosomal recessive genetic disease, and a type of hereditary metabolic disease that can be treated through dietary control. All natural foods contain certain amounts of phenylalanine. Therefore, once diagnosed, children should stop consuming natural diets and start treatment with a phenylalanine-restricted diet, including low-phenylalanine yogurt. Treatment should continue at least until the age of 12. When the concentration of blood phenylalanine is controlled at an ideal level, gradually add small amounts of natural food, adhering to the principle of low protein and low phenylalanine in the added foods.