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Mild phenylketonuria

MedGen UID:
1842357
•Concept ID:
C5680203
•
Disease or Syndrome
Synonyms: mild phenylketonuria; Mild PKU; mild PKU; mPKU; Variant phenylketonuria; variant phenylketonuria; Variant PKU; variant PKU
Modes of inheritance:
Autosomal recessive inheritance
MedGen UID:
141025
•Concept ID:
C0441748
•
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in individuals with two pathogenic alleles, either homozygotes (two copies of the same mutant allele) or compound heterozygotes (whereby each copy of a gene has a distinct mutant allele).
Autosomal recessive inheritance (Orphanet)
 
Monarch Initiative: MONDO:0019258
Orphanet: ORPHA79253

Definition

A mild to moderate form of phenylketouria (PKU), an inborn error of amino acid metabolism, characterized by blood phenylalanine concentrations of 600-1,200 micromol/L and manifests with reduced cognitive function and behavioral and developmental disorders. Dietary phenylalanine tolerance is 400-600 mg/day. [from ORDO]

Professional guidelines

PubMed

Genotype-phenotype associations in French patients with phenylketonuria and importance of genotype for full assessment of tetrahydrobiopterin responsiveness.
Jeannesson-Thivisol E, Feillet F, Chéry C, Perrin P, Battaglia-Hsu SF, Herbeth B, Cano A, Barth M, Fouilhoux A, Mention K, Labarthe F, Arnoux JB, Maillot F, Lenaerts C, Dumesnil C, Wagner K, Terral D, Broué P, de Parscau L, Gay C, Kuster A, Bédu A, Besson G, Lamireau D, Odent S, Masurel A, Guéant JL, Namour F
Orphanet J Rare Dis 2015 Dec 15;10:158. doi: 10.1186/s13023-015-0375-x. PMID: 26666653Free PMC Article
Phenylalanine hydroxylase deficiency in the Slovak population: genotype-phenotype correlations and genotype-based predictions of BH4-responsiveness.
Polak E, Ficek A, Radvanszky J, Soltysova A, Urge O, Cmelova E, Kantarska D, Kadasi L
Gene 2013 Sep 10;526(2):347-55. Epub 2013 Jun 10 doi: 10.1016/j.gene.2013.05.057. PMID: 23764561
Long-term treatment of patients with mild and classical phenylketonuria by tetrahydrobiopterin.
Trefz FK, Scheible D, Frauendienst-Egger G, Korall H, Blau N
Mol Genet Metab 2005 Dec;86 Suppl 1:S75-80. Epub 2005 Oct 20 doi: 10.1016/j.ymgme.2005.06.026. PMID: 16242984

Recent clinical studies

Etiology

Evaluation of patients with phenylalanine metabolism disorder: a single center experience.
Erdol S, Bilgin H
J Pediatr Endocrinol Metab 2022 Apr 26;35(4):463-467. Epub 2022 Jan 27 doi: 10.1515/jpem-2021-0737. PMID: 35084144
Phenylalanine hydroxylase deficiency.
Mitchell JJ, Trakadis YJ, Scriver CR
Genet Med 2011 Aug;13(8):697-707. doi: 10.1097/GIM.0b013e3182141b48. PMID: 21555948
Long-term treatment of patients with mild and classical phenylketonuria by tetrahydrobiopterin.
Trefz FK, Scheible D, Frauendienst-Egger G, Korall H, Blau N
Mol Genet Metab 2005 Dec;86 Suppl 1:S75-80. Epub 2005 Oct 20 doi: 10.1016/j.ymgme.2005.06.026. PMID: 16242984
Tetrahydrobiopterin as an alternative treatment for mild phenylketonuria.
Muntau AC, Röschinger W, Habich M, Demmelmair H, Hoffmann B, Sommerhoff CP, Roscher AA
N Engl J Med 2002 Dec 26;347(26):2122-32. doi: 10.1056/NEJMoa021654. PMID: 12501224
Intelligence in mild atypical phenylketonuria.
Costello PM, Beasley MG, Tillotson SL, Smith I
Eur J Pediatr 1994 Apr;153(4):260-3. doi: 10.1007/BF01954515. PMID: 8194559

Diagnosis

Efficacy and safety of BH4 before the age of 4 years in patients with mild phenylketonuria.
Leuret O, Barth M, Kuster A, Eyer D, de Parscau L, Odent S, Gilbert-Dussardier B, Feillet F, Labarthe F
J Inherit Metab Dis 2012 Nov;35(6):975-81. Epub 2012 Mar 3 doi: 10.1007/s10545-012-9464-3. PMID: 22388642
Phenylalanine hydroxylase deficiency.
Mitchell JJ, Trakadis YJ, Scriver CR
Genet Med 2011 Aug;13(8):697-707. doi: 10.1097/GIM.0b013e3182141b48. PMID: 21555948
Diagnosis of tetrahydrobiopterin (BH4) responsive mild phenylketonuria in Japan over the past 10 years.
Shintaku H, Ohwada M, Aoki K, Kitagawa T, Yamano T
Ann Acad Med Singap 2008 Dec;37(12 Suppl):77-2. PMID: 19904458
Long-term treatment of patients with mild and classical phenylketonuria by tetrahydrobiopterin.
Trefz FK, Scheible D, Frauendienst-Egger G, Korall H, Blau N
Mol Genet Metab 2005 Dec;86 Suppl 1:S75-80. Epub 2005 Oct 20 doi: 10.1016/j.ymgme.2005.06.026. PMID: 16242984
The metabolic and molecular bases of tetrahydrobiopterin-responsive phenylalanine hydroxylase deficiency.
Blau N, Erlandsen H
Mol Genet Metab 2004 Jun;82(2):101-11. doi: 10.1016/j.ymgme.2004.03.006. PMID: 15171997

Therapy

Efficacy and safety of BH4 before the age of 4 years in patients with mild phenylketonuria.
Leuret O, Barth M, Kuster A, Eyer D, de Parscau L, Odent S, Gilbert-Dussardier B, Feillet F, Labarthe F
J Inherit Metab Dis 2012 Nov;35(6):975-81. Epub 2012 Mar 3 doi: 10.1007/s10545-012-9464-3. PMID: 22388642
Phenylalanine hydroxylase deficiency.
Mitchell JJ, Trakadis YJ, Scriver CR
Genet Med 2011 Aug;13(8):697-707. doi: 10.1097/GIM.0b013e3182141b48. PMID: 21555948
Long-term treatment of patients with mild and classical phenylketonuria by tetrahydrobiopterin.
Trefz FK, Scheible D, Frauendienst-Egger G, Korall H, Blau N
Mol Genet Metab 2005 Dec;86 Suppl 1:S75-80. Epub 2005 Oct 20 doi: 10.1016/j.ymgme.2005.06.026. PMID: 16242984
The metabolic and molecular bases of tetrahydrobiopterin-responsive phenylalanine hydroxylase deficiency.
Blau N, Erlandsen H
Mol Genet Metab 2004 Jun;82(2):101-11. doi: 10.1016/j.ymgme.2004.03.006. PMID: 15171997
Tetrahydrobiopterin as an alternative treatment for mild phenylketonuria.
Muntau AC, Röschinger W, Habich M, Demmelmair H, Hoffmann B, Sommerhoff CP, Roscher AA
N Engl J Med 2002 Dec 26;347(26):2122-32. doi: 10.1056/NEJMoa021654. PMID: 12501224

Prognosis

Genotype-phenotype associations in French patients with phenylketonuria and importance of genotype for full assessment of tetrahydrobiopterin responsiveness.
Jeannesson-Thivisol E, Feillet F, Chéry C, Perrin P, Battaglia-Hsu SF, Herbeth B, Cano A, Barth M, Fouilhoux A, Mention K, Labarthe F, Arnoux JB, Maillot F, Lenaerts C, Dumesnil C, Wagner K, Terral D, Broué P, de Parscau L, Gay C, Kuster A, Bédu A, Besson G, Lamireau D, Odent S, Masurel A, Guéant JL, Namour F
Orphanet J Rare Dis 2015 Dec 15;10:158. doi: 10.1186/s13023-015-0375-x. PMID: 26666653Free PMC Article
Phenylalanine hydroxylase deficiency in the Slovak population: genotype-phenotype correlations and genotype-based predictions of BH4-responsiveness.
Polak E, Ficek A, Radvanszky J, Soltysova A, Urge O, Cmelova E, Kantarska D, Kadasi L
Gene 2013 Sep 10;526(2):347-55. Epub 2013 Jun 10 doi: 10.1016/j.gene.2013.05.057. PMID: 23764561
Assessment of tetrahydrobiopterin responsiveness in Turkish hyperphenylalaninemic patients.
Yildirim S, Tokatli A, Yilmaz E, Coşkun T
Turk J Pediatr 2007 Jan-Mar;49(1):1-6. PMID: 17479638
Tetrahydrobiopterin as an alternative treatment for mild phenylketonuria.
Muntau AC, Röschinger W, Habich M, Demmelmair H, Hoffmann B, Sommerhoff CP, Roscher AA
N Engl J Med 2002 Dec 26;347(26):2122-32. doi: 10.1056/NEJMoa021654. PMID: 12501224
The phenylketonuria locus: current knowledge about alleles and mutations of the phenylalanine hydroxylase gene in various populations.
Konecki DS, Lichter-Konecki U
Hum Genet 1991 Aug;87(4):377-88. doi: 10.1007/BF00197152. PMID: 1679029

Clinical prediction guides

Genotype-phenotype associations in French patients with phenylketonuria and importance of genotype for full assessment of tetrahydrobiopterin responsiveness.
Jeannesson-Thivisol E, Feillet F, Chéry C, Perrin P, Battaglia-Hsu SF, Herbeth B, Cano A, Barth M, Fouilhoux A, Mention K, Labarthe F, Arnoux JB, Maillot F, Lenaerts C, Dumesnil C, Wagner K, Terral D, Broué P, de Parscau L, Gay C, Kuster A, Bédu A, Besson G, Lamireau D, Odent S, Masurel A, Guéant JL, Namour F
Orphanet J Rare Dis 2015 Dec 15;10:158. doi: 10.1186/s13023-015-0375-x. PMID: 26666653Free PMC Article
Long-term treatment of patients with mild and classical phenylketonuria by tetrahydrobiopterin.
Trefz FK, Scheible D, Frauendienst-Egger G, Korall H, Blau N
Mol Genet Metab 2005 Dec;86 Suppl 1:S75-80. Epub 2005 Oct 20 doi: 10.1016/j.ymgme.2005.06.026. PMID: 16242984
Mechanisms underlying responsiveness to tetrahydrobiopterin in mild phenylketonuria mutations.
Pey AL, Pérez B, Desviat LR, Martínez MA, Aguado C, Erlandsen H, Gámez A, Stevens RC, Thórólfsson M, Ugarte M, Martínez A
Hum Mutat 2004 Nov;24(5):388-99. doi: 10.1002/humu.20097. PMID: 15459954
Tetrahydrobiopterin as an alternative treatment for mild phenylketonuria.
Muntau AC, Röschinger W, Habich M, Demmelmair H, Hoffmann B, Sommerhoff CP, Roscher AA
N Engl J Med 2002 Dec 26;347(26):2122-32. doi: 10.1056/NEJMoa021654. PMID: 12501224
The phenylketonuria locus: current knowledge about alleles and mutations of the phenylalanine hydroxylase gene in various populations.
Konecki DS, Lichter-Konecki U
Hum Genet 1991 Aug;87(4):377-88. doi: 10.1007/BF00197152. PMID: 1679029

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