Can phenylketonuria cause hair to turn white?

Written by Zeng Hai Jiang
Pediatrics
Updated on November 20, 2024
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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.

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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 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 Hu Qi Feng
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Phenylketonuria Clinical Symptoms

Phenylketonuria may appear normal at birth, but symptoms usually start to appear between three to six months, with the symptoms becoming most evident at one year old. These are often manifestations of the nervous system, with prominent developmental delays in intelligence. The IQ is often lower than normal, and there may be abnormal behaviors, minor epileptic seizures, and, in a few children, increased muscle tone and hyperactive tendon reflexes. Due to insufficient melanin synthesis a few months after birth, affected children’s hair color changes from black to yellow, their skin is fair, and skin eczema is relatively common. Due to the elevated excretion of phenylacetic acid in urine and sweat, there is a distinct mouse-like urine smell.

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Written by Yan Xin Liang
Pediatrics
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Clinical symptoms of phenylketonuria

The clinical symptoms of phenylketonuria generally include normal appearance at birth, with symptoms usually appearing between three to six months, and becoming more pronounced by the age of one. The most noticeable initial symptoms involve the nervous system; delayed intellectual development is prominent, with intelligence often below normal, along with behavioral abnormalities such as hyperactivity, depression, restlessness, and withdrawal. There could be minor epileptic seizures, and in some cases, increased muscle tone or exaggerated tendon reflexes. Regarding the skin, several months after birth, due to insufficient melanin synthesis, the child’s hair changes from black to yellow, the skin appears pale, and eczema is also relatively common. Additionally, the urine and sweat contain higher levels of phenylacetic acid, which can result in a distinctive mouse-like urine odor.

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Written by Yan Xin Liang
Pediatrics
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How to diagnose phenylketonuria?

Phenylketonuria is a treatable hereditary metabolic disease, where our primary goal is early diagnosis and treatment. Currently, a universal newborn screening system has been widely implemented. The standard procedure requires that after three days of breastfeeding, peripheral blood is collected from the newborn's heel, dropped onto specialized blood collection filter paper, and, once dried, sent to a screening laboratory to measure the phenylalanine concentration. If the phenylalanine concentration exceeds the cutoff value, further differential diagnosis and confirmation are conducted. Treatment typically starts two to three weeks after birth, and the prognosis is good. Additionally, diagnostic tests for phenylketonuria include urine ferric chloride, 2,4-dinitrophenylhydrazine tests, urinary purine profile analysis, and tetrahydrobiopterin loading test. Another method is through DNA analysis.