Phenylketonuria is what type of inheritance?

Written by Yan Xin Liang
Pediatrics
Updated on May 15, 2025
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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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When do people with phenylketonuria need to eat a special diet until?

Phenylketonuria is the first genetic metabolic disease that can be treated through dietary control. Since natural foods contain certain amounts of phenylalanine, once children with phenylketonuria are diagnosed, they should stop consuming a natural diet and start a low-phenylalanine diet treatment. 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, gradually small amounts of natural diet can be reintroduced. The food added should adhere to the principles of being low in protein and phenylalanine.

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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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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 Wang Lin Zhong
Pediatrics
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Early symptoms of phenylketonuria

Phenylketonuria is a hereditary metabolic disease caused by a deficiency or low activity of phenylalanine hydroxylase. Its main clinical manifestations include very obvious developmental delays in children and significantly lower IQ than their peers, severely affecting the child's growth and development. Due to the lack of this enzyme, the increase of abnormal metabolic products affects brain function, leading to symptoms such as seizures, convulsions, increased muscle tone, as well as hyperactivity and restlessness in children. The skin becomes particularly dry, prone to eczema, appears pale, and the hair turns yellow. The urine has a distinct mouse-like odor. Once diagnosed, early treatment is essential to reduce the sequelae of brain damage. The earlier the treatment, the better the prognosis. For these children, a special formula is needed, which is low in phenylalanine.

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Written by Hu Qi Feng
Pediatrics
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How is phenylketonuria diagnosed?

Phenylketonuria screening is routinely conducted in China for all newborns. This involves pricking the heel to collect peripheral blood, which is then dropped on specialized filter paper and dried. The samples are sent to a screening laboratory for the measurement of phenylalanine concentration. If the concentration exceeds the threshold, further testing for phenylalanine is conducted. Normally, the concentration should be less than 120 micromoles per liter. Additionally, an analysis of the urinary purine profile can be performed.