eMedicine Specialties > Pediatrics: Genetics and Metabolic Disease > Metabolic Diseases
Hyperphenylalaninemia: Follow-up
Updated: Feb 13, 2009
Follow-up
Further Outpatient Care
- Phenylalanine levels determine the need for further outpatient care in patients with hyperphenylalaninemia.
Deterrence/Prevention
- In general, patients should avoid consuming aspartame because phenylalanine is a primary component of aspartame.
Prognosis
- Prognosis is excellent for normal development when treated as indicated.
Patient Education
- Teach patients and parents about proper diet. Children should participate in their dietary planning as soon as they have that ability.
Miscellaneous
Medicolegal Pitfalls
- Failure to provide adequate dietary phenylalanine, an essential amino acid
- Failure to recommend adequate phenylalanine restriction
- Failure to acknowledge the teratogenic effects of phenylalanine in pregnant women
Special Concerns
- Excessively low phenylalanine levels can cause poor growth; all patients on dietary restrictions require careful follow-up.
- Although elevated maternal phenylalanine levels are associated with birth defects, excessively low levels during pregnancy are also associated with poor fetal growth and microcephaly.
- A few patients with mild-to-moderate elevations of phenylalanine later present with levels requiring dietary treatment. For this reason, follow-up over time is recommended.
More on Hyperphenylalaninemia |
| Overview: Hyperphenylalaninemia |
| Differential Diagnoses & Workup: Hyperphenylalaninemia |
| Treatment & Medication: Hyperphenylalaninemia |
Follow-up: Hyperphenylalaninemia |
| Multimedia: Hyperphenylalaninemia |
| References |
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References
Burton BK, Grange DK, Milanowski A, et al. The response of patients with phenylketonuria and elevated serum phenylalanine to treatment with oral sapropterin dihydrochloride (6R-tetrahydrobiopterin): a phase II, multicentre, open-label, screening study. J Inherit Metab Dis. Oct 2007;30(5):700-7. [Medline].
Matalon R, Michals-Matalon K, Koch R, et al. Response of patients with phenylketonuria in the US to tetrahydrobiopterin. Mol Genet Metab. Dec 2005;86 Suppl 1:S17-21. [Medline].
Sarkissian CN, Gamez A, Wang L, et al. Preclinical evaluation of multiple species of PEGylated recombinant phenylalanine ammonia lyase for the treatment of phenylketonuria. Proc Natl Acad Sci U S A. Dec 30 2008;105(52):20894-9. [Medline].
Agostoni C, Verduci E, Massetto N, et al. Long term effects of long chain polyunsaturated fats in hyperphenylalaninemic children. Arch Dis Child. Jul 2003;88(7):582-3. [Medline].
Berlin CM, Levy HL, Hanley WB. Delayed increase in blood phenylalanine concentration in phenylketonuric children initially classified as mild hyperphenylalaninemia. Screening. 1995;4:35-39.
Diamond A, Prevor MB, Callender G. Prefrontal cortex cognitive deficits in children treated early and continuously for PKU. Monogr Soc Res Child Dev. 62(4):i-v, 1-208. [Medline].
Fisch RO, Matalon R, Weisberg S, Michals K. Phenylketonuria: current dietary treatment practices in the United States and Canada. J Am Coll Nutr. Apr 1997;16(2):147-51. [Medline].
Gassio R, Artuch R, Vilaseca MA, et al. Cognitive functions in classic phenylketonuria and mild hyperphenylalaninemia: experience in a pediatric population. Dev Med Child Neurol. 2005;47:443-8. [Medline].
Medical Research Council Working Party on Phenylketonuria. Recommendations on the dietary management of phenylketonuria. Arch Dis Child. Mar 1993;68(3):426-7. [Medline].
Scriver CR, Kaufman S, Eijsensmith RC. The hyperphenylalaninemias. In: The Metabolic and Molecular Bases of Inherited Disease. Vol 1. 1995:1015-76.
Further Reading
Keywords
hyperphenylalaninemia, phenylketonuria, benign PKU, mild PKU, nonphenylketonuric hyperphenylalaninemia, phenylalanine, microcephaly, mental retardation, birth defects, maternal hyperphenylalaninemia, tetrahydrobiopterin deficiency, enzyme defect
Follow-up: Hyperphenylalaninemia