Is phenylketonuria often misdiagnosed?

Written by Yao Li Qin
Pediatrics
Updated on February 16, 2025
00:00
00:00

Phenylketonuria belongs to congenital hereditary metabolic disorders and is caused by enzyme deficiencies in the phenylalanine metabolic pathway. Misdiagnosis of phenylketonuria is not common; if the disease develops, meaning that the child has typical clinical manifestations, it is relatively easy to diagnose. However, once a child exhibits the typical clinical manifestations of phenylketonuria such as blood phenylalanine levels, by the time of diagnosis the child may already have varying degrees of neurological damage, meaning the child might already have intellectual disabilities. Therefore, in such cases, we cannot rely solely on clinical symptoms for diagnosis but should instead carry out newborn disease screening promptly after birth. By diagnosing and treating before any clinical symptoms appear, we can prevent the occurrence of neurological complications, allowing the child to grow and develop like a normal child.

Other Voices

doctor image
home-news-image
Written by Zeng Hai Jiang
Pediatrics
48sec home-news-image

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.

doctor image
home-news-image
Written by Zeng Hai Jiang
Pediatrics
50sec home-news-image

Can phenylketonuria cause hair to turn white?

Phenylketonuria is caused by a mutation in the phenylalanine hydroxylase gene, resulting in reduced or lost enzyme activity, and a metabolic disorder of phenylalanine in the liver. Children with phenylketonuria lack phenylalanine hydroxylase, leading to reduced tyrosine and normal metabolic products. The content of phenylalanine in the blood increases, secondary metabolic pathways are enhanced, producing phenylpyruvic acid, phenylacetic acid, and phenyllactic acid, which are excreted in large amounts in the urine. High concentrations of phenylalanine and its abnormal metabolic products inhibit tyrosinase, leading to disturbances in melanin synthesis. Therefore, untreated children will gradually show changes in hair color from black to yellow and skin lightening after three months.

doctor image
home-news-image
Written by Yan Xin Liang
Pediatrics
40sec home-news-image

Phenylketonuria patients lack phenylalanine hydroxylase.

Phenylketonuria is an autosomal recessive genetic disorder caused by mutations in the phenylalanine hydroxylase gene, leading to reduced enzyme activity and resulting in the accumulation of phenylalanine and its metabolic products in the body, causing the disease. Phenylketonuria is the most common congenital amino acid metabolism disorder, clinically presenting with intellectual developmental delays, lighter skin and hair pigmentation, and a musty urine odor. The disease is mainly caused by mutations in the phenylalanine hydroxylase gene, leading to reduced enzyme activity.

doctor image
home-news-image
Written by Zeng Hai Jiang
Pediatrics
40sec home-news-image

Does phenylketonuria require a lifetime of special milk consumption?

Phenylketonuria does not require a lifetime of special milk consumption. It is the first genetically inherited metabolic disorder that can be treated through dietary control. Once diagnosed with phenylketonuria, one must stop a natural diet and begin treatment with a low-phenylalanine diet. The low-phenylalanine milk formula should be consumed at least until the age of 12. When the concentration of phenylalanine in the blood is controlled within the ideal range, it is possible to appropriately add a small amount of natural diet, adhering to principles of low protein and low phenylalanine.

doctor image
home-news-image
Written by Yan Xin Liang
Pediatrics
1min 7sec home-news-image

Can phenylketonuria be cured?

Phenylketonuria is one of the few treatable genetic metabolic diseases. It strives for early diagnosis and treatment to avoid irreversible damage to the nervous system. Once diagnosed, aggressive treatment should be given. The younger the age at which treatment starts, the better the effect. The main approach is to use a low-phenylalanine formula milk. When the blood concentration drops to a normal level, natural diet can gradually be added in small amounts, with breast milk being the preferred choice, as it contains only one-third the phenylalanine of cow's milk. Larger infants can add cow's milk, porridge, noodles, eggs, etc. The added foods should also follow the principle of being low in protein and low in phenylalanine, because concentrations of phenylalanine that are too high or too low will affect growth and development. Low-phenylalanine treatment should continue at least until after puberty. Lifelong treatment is more beneficial for patients. This disease can only control symptoms, and lifelong treatment is the best; it cannot be completely cured.