Phenylketonuria in adulthood: A collaborative study

R. Koch*, B. Burton, G. Hoganson, R. Peterson, W. Rhead, B. Rouse, R. Scott, J. Wolff, A. M. Stern, F. Guttler, M. Nelson, F. De la Cruz, J. Coldwell, R. Erbe, M. T. Geraghty, C. Shear, J. Thomas, C. Azen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

172 Scopus citations

Abstract

During 1967-1983, the Maternal and Child Health Division of the Public Health Services funded a collaborative study of 211 newborn infants identified on newborn screening as having phenylketonuria (PKU). Subsequently, financial support was provided by the National Institute of Child Health and Human Development (NICHD). The infants were treated with a phenylalanine (Phe)-restricted diet to age 6 years and then randomized either to continue the diet or to discontinue dietary treatment altogether. One hundred and twenty-five of the 211 children were then followed until 10 years of age. In 1998, NICHD scheduled a Consensus Development Conference on Phenylketonuria and initiated a study to follow up the participants from the original Collaborative Study to evaluate their present medical, nutritional, psychological, and socioeconomic status. Fourteen of the original clinics (1967-1983) participated in the Follow-up Study effort. Each clinic director was provided with a list of PKU subjects who had completed the original study (1967-1983), and was asked to evaluate as many as possible using a uniform protocol and data collection forms. In a subset of cases, magnetic resonance imaging and spectroscopy (MRI/MRS) were performed to study brain Phe concentrations. The medical evaluations revealed that the subjects who maintained a phenylalanine-restricted diet reported fewer problems than the diet discontinuers, who had an increased rate of eczema, asthma, mental disorders, headache, hyperactivity and hypoactivity. Psychological data showed that lower intellectual and achievement test scores were associated with dietary discontinuation and with higher childhood and adult blood Phe concentrations. Abnormal MRI results were associated with higher brain Phe concentrations. Early dietary discontinuation for subjects with PKU is associated with poorer outcomes not only in intellectual ability, but also in achievement test scores and increased rates of medical and behavioural problems.

Original languageEnglish (US)
Pages (from-to)333-346
Number of pages14
JournalJournal of inherited metabolic disease
Volume25
Issue number5
DOIs
StatePublished - Sep 2002

Funding

Summary: During 1967^1983, the Maternal and Child Health Division of the Public Health Services funded a collaborative study of 211 newborn infants identi-¢ed on newborn screening as having phenylketonuria (PKU). Subsequently, ¢nancial support was provided by the National Institute of Child Health and Human Development (NICHD). The infants were treated with a phenylalanine (Phe)-restricted diet to age 6 years and then randomized either to continue the diet or to discontinue dietary treatment altogether. One hundred and twenty-¢ve of the 211 children were then followed until 10 years of age. In 1998, NICHD scheduled a Consensus Development Conference on Phenylketonuria and initiated a study to follow up the participants from the original Collaborative Funded by NIH Contract No. N01-HD-2-3148 from the National Institute of Child Health and Human Development, Bethesda, Maryland; Childrens’ Hospital Los Angeles Research Institute, Keck School of Medicine, Los Angeles, California. Computational assistance was provided by the NIH NCRR GCRC M01 RR-43 CDMAS Project and was performed at the GCRC at Children’s Hospital Los Angeles, Los Angeles, California.

ASJC Scopus subject areas

  • Genetics(clinical)
  • Genetics

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