Causes of Phenylketonuria

Written by Yan Xin Liang
Pediatrics
Updated on September 28, 2024
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The cause of phenylketonuria is that phenylalanine is an essential amino acid for the human body. Some of the phenylalanine ingested is used for protein synthesis, while another part is converted into tyrosine by the action of phenylalanine hydroxylase. Only a small amount of phenylalanine undergoes a secondary metabolic pathway and is converted into phenylpyruvate under the action of transaminase. Due to the reduced activity of phenylalanine hydroxylase in affected children, phenylalanine cannot be converted into tyrosine, leading to an extremely high concentration of phenylalanine in blood, cerebrospinal fluid, and tissues. This, through a bypass metabolic pathway, results in the production of a large amount of phenylpyruvate, phenylacetate, phenyllactate, and p-hydroxyphenylacetate. The high concentration of phenylalanine and its metabolic products then leads to brain damage, which is the cause of the disease.

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Written by Yan Xin Liang
Pediatrics
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Phenylketonuria has what symptoms?

Phenylketonuria is an autosomal recessive genetic disorder. It is the most common congenital amino acid metabolism disorder. Its main clinical characteristics include intellectual disability, light skin and hair pigmentation, and a mousy urine odor. This name arises from the excretion of large amounts of phenylketonic acid metabolites in children's urine, which leads to the characteristic odor. Typically, affected children appear normal at birth, but symptoms usually begin to appear between three to six months of age, with most significant symptoms evident by one year. The most prominent issue is delayed intellectual development, with intelligence quotients often falling below normal. Skin pigmentation usually becomes lighter several months after birth due to insufficient melanin synthesis, resulting in hair turning from black to yellow and a paler skin complexion. Additionally, a distinct mousy body odor is produced due to the excretion of excessive phenylacetic acid in urine and sweat.

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Written by Yan Xin Liang
Pediatrics
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How is phenylketonuria cured?

Phenylketonuria is an autosomal recessive genetic disease, primarily due to a mutation in the phenylalanine hydroxylase gene which leads to reduced enzymatic activity, causing the accumulation of phenylalanine and its metabolites in the body, thereby leading to this disease. The main manifestations include developmental intellectual disabilities, light skin and hair pigmentation, and a musty urine odor. Once diagnosed, immediate treatment is necessary, mainly using a low-phenylalanine formula milk. Generally, when orally administering low-phenylalanine formula milk, it is essential to monitor the phenylalanine levels in the blood. Since each patient has a different tolerance level for phenylalanine, periodic determination of blood phenylalanine concentration is required in the dietary treatment. Such patients can only be treated long-term in this way; it is not curable nor can it be completely eradicated; treatment can only alleviate the symptoms and involves long-term administration of a low-phenylalanine diet.

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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 Yan Xin Liang
Pediatrics
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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.

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Written by Yan Xin Liang
Pediatrics
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Does phenylketonuria affect intelligence?

Phenylketonuria is a common amino acid metabolic disease, primarily caused by a deficiency of phenylalanine hydroxylase in the metabolic pathway of phenylalanine, preventing phenylalanine from converting into tyrosine. This leads to the accumulation of phenylalanine and its ketones in the body, which are then excreted in large amounts through urine. Its clinical manifestations are not uniform. The main clinical characteristic is intellectual disability, thus it does affect intelligence. Additionally, it can present various neuropsychiatric symptoms such as increased muscle tone, hyperreflexia, agitation, hyperactivity, convulsions, etc. It can also lead to reduced skin pigmentation and yellowing of hair among other symptoms. This disease can impact intelligence.