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(PKU) is a rare
genetic disorder in which the body cannot break down
an amino acid called phenylalanine (say "fehn-uhl-AL-uh-neen"), which is a part of protein. This substance is found in breast milk, many types of baby formula, and most foods, especially those with a lot of protein, such as meat, eggs, and dairy products. If PKU is not treated, phenylalanine can build up in the blood and lead to intellectual disability and problems with the central nervous system (brain and spinal cord).
The good news is that early treatment can prevent all or most problems. Babies born with PKU need to start treatment with special formula soon after birth.
PKU is passed down through
families. To have the disease, a baby must get the
gene from both parents. If a baby gets the gene from
only one parent, he or she is a
carrier of the PKU gene but does not have the
If you have a child with PKU and are thinking about having another baby, you may want to get genetic counseling. If you have a family history of PKU, talk with your doctor about genetic testing if you want to find out whether you carry the gene.
If PKU is not found and treated soon after birth, symptoms usually start
to appear within a few months after birth. (It takes time for the phenylalanine to build up in the baby's
Early symptoms of
PKU in a baby may include:
Without early treatment, the child may have
developmental delays, seizures, and severe
Screening is recommended for all newborns within a few days after
birth.1 If the PKU screening test shows that your baby has a phenylalanine problem, the doctor will do further testing to check whether your baby has PKU.
Finding and starting treatment for PKU
early usually can prevent brain damage and other long-term problems.
The main treatment for PKU is a
lifelong reduced-protein diet. Problems are less likely to occur if your baby starts a PKU diet by age 3 weeks. Your baby's doctor can help you choose a formula that doesn't contain phenylalanine. You may be able to feed your baby some breast milk, but
talk to your baby's doctor first. As your child gets older, a
registered dietitian can help you choose the right
foods and recipes.
The medicine sapropterin (Kuvan) may help lower phenylalanine levels in some children who have PKU. More studies are needed to find out the health effects from long-term use. With or without the medicine, your child still needs to follow a PKU diet.
Your child will need regular blood tests. He or she may get tested as often as once a week for the first year and then once or twice a month throughout childhood.
normal to feel a wide range of emotions when your child has an illness like PKU. You may want to join a support group.
Your doctor can also help.
People who have PKU need to follow a reduced-protein diet throughout their lives. For a few people, treatment with sapropterin (Kuvan) may help when used with a PKU diet. Talk to your doctor about the pros and cons of this medicine.
You'll need regular blood tests to check your phenylalanine level. Testing once a month is suggested.2 If the level builds up, it can affect your IQ and your ability to learn, think, and understand.
Any woman with PKU who is planning to have a baby needs to be very careful to control her phenylalanine levels. Babies born to mothers who
have high levels of phenylalanine are at risk for having a very small head, intellectual disability, growth problems, and heart problems. Having regular blood tests and following the PKU diet before and during pregnancy can help protect the baby.
Learning about phenylketonuria (PKU):
The Children's PKU Network is a nonprofit organization that offers
networking services, resources, a hotline, and family support.
The Genetics Home Reference provides information on hundreds of genetic conditions. The website has many tools for learning about human genetics and the way genetic changes can cause
disease. It also has links to additional resources for people who
have genetic conditions and for their families.
The March of Dimes tries to improve the health of babies
by preventing birth defects, premature birth, and early death. March of Dimes
supports research, community services, education, and advocacy to save babies'
lives. The organization's website has information on premature birth, birth
defects, birth defects testing, pregnancy, and prenatal care.
The National Institute of Child Health and Human
Development (NICHD) is part of the U.S. National Institutes of Health. The
NICHD conducts and supports research related to the health of children, adults,
and families. NICHD has information on its Web site about many health topics.
And you can send specific requests to information specialists.
This organization creates a newsletter and
develops other materials (such as diet information and recipes) for
people with phenylketonuria (PKU) and for their families. The website includes
treatment and support group information, an email discussion group,
and links to related websites.
CitationsU.S. Preventive Services Task Force (2008). Screening for phenylketonuria. Available online:National Institutes of Health (2000). Phenylketonuria (PKU): Screening and management. NIH Consensus Statement, 17(3): 1–33.Other Works ConsultedAminoff M (2009). Metabolic disorders section of Neurologic disorders. In RK Creasy et al., eds., Creasy and Resnik's Maternal-Fetal Medicine, 6th ed., pp. 1101–1102. Philadelphia: Saunders Elsevier.Durkin MS, et al. (2008). Childhood cognitive disability. In RB Wallace et al., eds., Wallace/Maxcy-Rosenau-Last Public Health and Preventive Medicine, 15th ed., pp. 1173–1183. New York: McGraw-Hill.Feillet F, et al. (2010). Challenges and pitfalls in the management of phenylketonuria. Pediatrics, 126(2): 333–341.Poustie VJ, Wildgoose J (2010). Dietary interventions for phenylketonuria. Cochrane Database of Systematic Reviews (1).Sapropterin (Kuvan) for phenylketonuria (2008). Medical Letter on Drugs and Therapeutics, 50(1287): 43–44.Schwahn BC (2011). Hyperphenylalaninemias. In CD Rudolph et al., eds., Rudolph's Pediatrics, 22nd ed., pp. 561–563. New York: McGraw-Hill.Somaraju UR, Merrin M (2010). Sapropterin dihydrochloride for phenylketonuria. Cochrane Database of Systematic Reviews (6).Thomas JA, Van Hove JLK (2011). Phenylketonuria and the hyperphenylalaninemias section of Inborn errors of metabolism. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 20th ed., pp. 1002–1003. New York: McGraw-Hill.
September 8, 2011
John Pope, MD - Pediatrics & Chuck Norlin, MD - Pediatrics
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