Is the incidence of phenylketonuria high?

Written by Yan Xin Liang
Pediatrics
Updated on September 27, 2024
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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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What is the normal value for phenylketonuria?

Phenylketonuria is a common autosomal recessive genetic disorder and the most common congenital amino acid metabolism disorder. It primarily manifests as intellectual disability, light skin and hair pigmentation, and a mousey urine odor. Newborn screening includes routine screening for phenylketonuria as it is a treatable hereditary metabolic disorder, emphasizing the importance of early diagnosis and treatment. Nowadays, newborn screening systems are widely implemented. Generally, this involves collecting a blood sample through a heel prick, dropping the blood on specialized filter paper, and then air drying before sending it to a screening laboratory to measure the phenylalanine concentration. Typically, a normal concentration should be less than 120 micromoles per liter. If the phenylalanine concentration exceeds 1200 micromoles per liter, it can be diagnosed as classical phenylketonuria.

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Written by Zeng Hai Jiang
Pediatrics
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Does phenylketonuria require lifelong dietary control?

Theoretically, phenylketonuria requires lifelong dietary control. Phenylketonuria is caused by a deficiency in phenylalanine hydroxylase in the metabolic pathway of phenylalanine, leading to disordered metabolism of phenylalanine in the liver. Phenylketonuria is the first genetic metabolic disease that can be managed through diet. Since natural foods all contain certain amounts of phenylalanine, once diagnosed, affected children should cease consuming natural diets and should be treated with a low-phenylalanine diet. Treatment with a low-phenylalanine formula should continue at least until the age of 12. When the concentration of phenylalanine in the blood is controlled at an ideal level, natural foods can gradually be reintroduced in small amounts. The reintroduction of food should still follow the principles of low protein and low phenylalanine. The types and amounts of food that each child can add vary individually and are related to the severity of the enzyme deficiency.

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Written by Zeng Hai Jiang
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Can patients with phenylketonuria eat fish and shrimp?

Children with phenylketonuria cannot eat fish and shrimp because phenylketonuria is caused by a deficiency of phenylalanine hydroxylase in the phenylalanine metabolic pathway, leading to metabolic disorder of phenylalanine in the liver. Phenylketonuria is the first hereditary metabolic disease that can be controlled by diet, as natural foods contain certain amounts of phenylalanine. Therefore, once diagnosed, children with phenylketonuria should stop consuming a natural diet and should be treated with a low phenylalanine diet. Fish and shrimp contain rich protein and high levels of phenylalanine, hence children with phenylketonuria cannot eat fish and shrimp.

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Written by Zeng Hai Jiang
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Can phenylketonuria eat corn?

People with phenylketonuria can eat corn. Phenylketonuria is a hereditary metabolic disease that can be treated through dietary control. Once diagnosed with phenylketonuria, one must stop a natural diet and switch to a low-phenylalanine diet. When the concentration of phenylalanine in the blood drops to an ideal level, natural foods can be gradually reintroduced in small amounts, but the diet must still adhere to low-protein and low-phenylalanine standards. Corn mainly consists of starch and does not contain phenylalanine, so individuals with phenylketonuria can eat corn.

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Written by Yan Xin Liang
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Why does phenylketonuria lead to intellectual disability?

Phenylketonuria is a common amino acid metabolic disease, mainly due to the deficiency of phenylalanine hydroxylase, which prevents phenylalanine from being transformed into tyrosine, leading to the accumulation of phenylalanine and its keto acids. Due to the lack of tyrosine in the body, it affects the growth and development of the brain, resulting in intellectual developmental delays. Therefore, children with phenylketonuria often exhibit intellectual disabilities, as well as some psychiatric and neurological symptoms, such as increased muscle tone, restlessness, hyperactivity, abnormal behavior, and heightened excitability.