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Fenilcetonúria

Last reviewed: 17 Aug 2025
Last updated: 20 May 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • rastreamento neonatal positivo para fenilcetonúria
Full details

Other diagnostic factors

  • deficiência intelectual
  • microcefalia
  • eczema
  • pigmentação clara dos olhos e do cabelo
  • convulsões
  • odor de bolor da urina
Full details

Risk factors

  • história familiar de fenilcetonúria (PKU)
  • ascendência branca
Full details

Diagnostic tests

1st tests to order

  • rastreamento neonatal para transtornos metabólicos
Full details

Tests to consider

  • análise quantitativa de aminoácido plasmático
  • ensaio de di-hidropteridina redutase (DHPR) no sangue
  • proporção neopterina/biopterina urinária
  • análise da mutação do gene da fenilalanina hidroxilase
  • teste de responsividade à BH4
Full details

Treatment algorithm

ACUTE

todos os pacientes

Contributors

Authors

Barbara K. Burton, MD

Professor of Pediatrics

Northwestern University Feinberg School of Medicine

Director

PKU Clinic

Ann and Robert H. Lurie Children’s Hospital of Chicago

Chicago

IL

Disclosures

BKB has received consulting fees from Biomarin, PTC Therapeutics, and Jnana.

Peer reviewers

Berthold Koletzko, MD

Professor of Pediatrics

University of Munich

Head of Division of Metabolic Diseases and Nutritional Medicine

Dr von Hauner Children's Hospital

Ludwig-Maximilians-University of Munich

Lindwurmstr

Germany

Disclosures

BK has received research support from Danone Medical Nutrition and is the recipient of a Freedom to Discover Award of the Bristol Myers Squibb Foundation.

Stephanie Sacharow, MD

Medical Geneticist

Division of Genetics and Genomics

Boston Children's Hospital

Boston

MA

Disclosures

SS has participated on advisory boards and has given talks at conferences sponsored by Biomarin. She has been a principal investigator in studies with Biomarin, Synlogic, and PTC Therapeutics.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

National Institutes of Health Consensus Development Panel. National Institutes of Health consensus development conference statement: phenylketonuria - screening and management. 2000 [internet publication].Full text

Smith WE, Berry SA, Bloom K, et al. Phenylalanine hydroxylase deficiency diagnosis and management: a 2023 evidence-based clinical guideline of the American College of Medical Genetics and Genomics (ACMG). Genet Med. 2025 Jan;27(1):101289.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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