How is phenylketonuria tested?

Written by Yan Xin Liang
Pediatrics
Updated on January 23, 2025
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Phenylketonuria is a treatable inherited metabolic disease, and early diagnosis is essential for early treatment. Currently, we have generally implemented a newborn disease screening system that requires collecting peripheral blood by pricking the heel of newborns after three days of breastfeeding, dropping the blood onto specialized filter paper and sending it to a screening laboratory for phenylalanine concentration measurement. If the concentration exceeds the confirmed value, further differential diagnosis and confirmation are needed. If treatment can begin early, especially within two to three weeks after birth, the prognosis is generally good. Normally, the concentration is less than 120 µmol/L; a fetal concentration of 1200 µmol/L would be considered mild phenylketonuria.

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Written by Zeng Hai Jiang
Pediatrics
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How to determine if phenylketonuria is mild

Phenylketonuria severity is generally determined by clinical manifestations and blood phenylalanine concentration. Mild phenylketonuria is characterized by mild or asymptomatic intelligence, motor, and developmental delays, light hair and skin color, and a musty odor in urine and sweat. It includes clinical features such as seizures accompanied by abnormal mental and behavioral symptoms, with blood phenylalanine levels less than 120 to 360 micromoles per liter. This is primarily seen in a very small number of newborns or premature infants, or in cases where there is higher residual activity of phenylalanine hydroxylase enzyme.

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Written by Yan Xin Liang
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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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Can people with phenylketonuria eat meat?

Children with phenylketonuria should not eat meat and should try to eat as little as possible. Phenylketonuria is caused by a defect in the phenylalanine hydroxylase enzyme in the phenylalanine metabolic pathway, which results in a metabolic disorder of phenylalanine in the liver. Phenylketonuria is the first hereditary metabolic disease that can be treated by dietary control. All natural foods contain a certain amount of phenylalanine. Once diagnosed, children should stop consuming a natural diet and be given a low-phenylalanine diet for treatment. Meat is rich in protein and also contains a high amount of phenylalanine, thus the intake of meat must be restricted or minimized.

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Written by Yan Xin Liang
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Can phenylketonuria be treated?

Can phenylketonuria be treated? Yes, it can be treated, and treatment should begin immediately once diagnosed. The younger the age at which treatment begins, the better the prognosis. Infants are generally treated with low-phenylalanine formula milk. Once the blood phenylalanine concentration drops to an ideal level, natural foods can gradually be added in small amounts, with a preference for adding breast milk, since it contains only one-third the phenylalanine content of cow's milk. Older infants and children can add foods like milk, porridge, noodles, and eggs. Added foods should follow the principle of being low in protein and phenylalanine. The amount and frequency of these foods should be determined based on the blood phenylalanine concentration. Concentrations that are too high or too low can affect the growth and development of the child. As each child's tolerance to phenylalanine concentration differs, it is necessary to regularly measure the blood phenylalanine concentration during dietary treatment and adjust the diet according to the specific situation of the child, avoiding increased phenylalanine levels or deficiency.

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Can people with phenylketonuria not eat things high in protein?

Phenylketonuria patients should avoid foods high in protein, as phenylketonuria is a common amino acid metabolism disorder caused by a deficiency of phenylalanine hydroxylase in the metabolic pathway of phenylalanine, leading to disordered metabolism of phenylalanine in the liver. Phenylketonuria is a hereditary metabolic disease that can be managed through diet. Natural foods contain certain amounts of phenylalanine. Once diagnosed, the patient should cease consuming natural diets and switch to a phenylalanine-restricted diet. Foods rich in protein have higher amounts of phenylalanine, thus, those with phenylketonuria should not consume foods high in protein.