2012, Number 6
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Acta Pediatr Mex 2012; 33 (6)
Biochemical evaluation of phenylketonuria (PKU): from diagnosis to treatment
Belmont-Martínez L, Fernández-Lainez C, Ibarra-González I, Guillén-López S, Monroy- Santoyo S, Vela-Amieva M
Language: Spanish
References: 12
Page: 296-300
PDF size: 76.45 Kb.
ABSTRACT
Non treated phenylketonuria (PKU) has serious consequences such as growth retardation and intellectual impairment along with symptoms
like erythematous eczema, fair skin and hair, seizures, autistic conduct and aggressive behavior.
Pre-symptomatic biochemical diagnosis consists of identifying patients by blood phenylalanine (Phe) quantification through newborn
screening. The confirmation is based on determining serum Phe and tyrosine levels.
There is a wide spectrum of hyperphenylalaninemia clinical presentation, which ranges from mild forms which do not require nutritional
treatment to the most severe form of the disease known as classic PKU.
The aim of treatment is to avoid irreversible neurological impairment by stabilizing blood Phe level and keeping it within therapeutic concentration
range.
Once PKU diagnosis has been established, there are several criteria to decide when it is necessary to initiate treatment, we start it if Phe
level is ≥ 360 micromol/L (6 mg/L).
Besides periodical Phe and Tyr testing, biochemical follow-up includes the measurement of necessary elements that guarantee normal
physical and intellectual development such as selenium, zinc, B12 vitamin, folates, iron and long chain fatty acids. Clinical context is as
important as biochemical status so periodic evaluation of nutritional, medical, social and psychological aspects should be included.
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