Does phenylketonuria require chromosome testing?

Written by Zeng Hai Jiang
Pediatrics
Updated on November 06, 2024
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Phenylketonuria is usually screened during the neonatal period through routine blood testing, where the level of phenylalanine in the blood is measured to screen each newborn. This enables early diagnosis and treatment, hence reducing the occurrence of intellectual disabilities. Phenylketonuria can also be screened prenatally before the birth of the newborn. It is an autosomal recessive genetic disorder, closely related to chromosomal abnormalities. Therefore, prenatal screening can be conducted by amniocentesis between the 16th to 20th weeks of pregnancy. Chromosomal abnormalities detected through the amniocentesis indicate that the fetus carries the pathogenic gene, meaning the child will be born with phenylketonuria. If both parents carry related genes, it is crucial to undergo prenatal screening and chromosomal analysis to eliminate the risk of the fetus developing the condition.

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Written by Zeng Hai Jiang
Pediatrics
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How long does it take for phenylketonuria to manifest?

Phenylketonuria is a common amino acid metabolic disease. Most infants appear normal at birth and do not show any specific clinical symptoms during the neonatal period, although some newborns may experience symptoms such as feeding difficulties, vomiting, or irritability. Symptoms of phenylketonuria gradually appear in the first three months after birth, including changes such as hair turning from black to yellow, skin whitening, delayed growth and intellectual development, seizures, hyperactive reflexes, eczema, etc. The sweat and urine of affected children will have a mouse-like odor.

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Written by Wu Ben Rong
Pediatrics
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Can phenylketonuria be treated with surgery?

Phenylketonuria (PKU) in children cannot be treated surgically. PKU is an autosomal recessive genetic disorder caused by a deficiency in the enzyme needed for the metabolic pathway of phenylalanine. Typically, there are no obvious symptoms in newborns, although some children may experience non-specific symptoms such as vomiting and feeding difficulties. If no relevant treatment is pursued, the child may gradually show signs of developmental delays in movement and intellect, and the hair might change from black to yellow while the skin tends to be paler. As the child grows older, the intellectual delays become more pronounced, and in severe cases, they might develop cerebral palsy. This disease can be treated in its early stages through dietary methods, and the younger the age at which treatment begins, the better the outcomes.

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Written by Zeng Hai Jiang
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Does phenylketonuria definitely cause intellectual disabilities when one grows up?

Phenylketonuria is a common amino acid metabolic disorder that is due to a deficiency of phenylalanine hydroxylase in the phenylalanine metabolic pathway, leading to metabolic disorder of phenylalanine in the liver. Phenylketonuria is the first genetic metabolic disorder that can be controlled and treated through diet. Once diagnosed, natural diet should be discontinued for the patient, and a low-phenylalanine diet should be administered. If phenylketonuria is diagnosed and treated early, intelligence can be normal. However, if not controlled, it can lead to delayed growth and development, especially in terms of intellectual development.

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Written by Yan Xin Liang
Pediatrics
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The causes of phenylketonuria

Phenylketonuria is a common autosomal recessive genetic disorder, the most frequent primary clinical manifestation among congenital amino acid metabolic disorders. It is characterized by intellectual disability, pale skin and hair pigmentation, and a mouse urine-like odor. The main cause is that phenylalanine is an essential amino acid for the human body. The phenylalanine ingested is partly used for protein synthesis and partly converted to tyrosine by the action of phenylalanine hydroxylase, which is necessary for the synthesis of substances like adrenaline, melanin, and thyroxine. The disease is mainly due to a deficiency of phenylalanine hydroxylase, which inhibits the conversion of phenylalanine to tyrosine, resulting in increased concentrations of phenylalanine in the blood, cerebrospinal fluid, and various tissues. At the same time, due to the predominance of the main pathway, the enhancement of the secondary metabolic pathway leads to the deamination of phenylalanine by transaminase, producing a large amount of phenylpyruvic acid, which through oxidation produces a large amount of phenylacetic acid, phenyllactic acid, and p-hydroxyphenylpyruvic acid. These metabolic by-products are excreted in large quantities in the urine, and the high concentrations of phenylalanine and its by-products accumulate extensively in brain tissue, thereby causing damage to brain cells.

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Written by Yan Xin Liang
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The earliest manifestation of phenylketonuria

Children with phenylketonuria usually start showing symptoms within 3 to 6 months after birth: Firstly, the nervous system is affected, which can be seen in developmental delays in intelligence, often with IQs lower than normal. Symptoms may include restlessness, depression, hyperactivity, or minor epileptic seizures. A few may exhibit increased muscle tone or heightened tendon reflexes. A few months after birth, due to insufficient melanin synthesis, the skin and hair undergo changes. Hair color may shift from black to yellow, the skin may appear very pale, and eczema is also more common. Additionally, because of the excretion of greater amounts of phenylacetic acids in urine and sweat, there may be a distinct mouse-like urine odor.