Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- rastreamento neonatal positivo para fenilcetonúria
Other diagnostic factors
- deficiência intelectual
- microcefalia
- eczema
- pigmentação clara dos olhos e do cabelo
- convulsões
- odor de bolor da urina
Risk factors
- história familiar de fenilcetonúria (PKU)
- ascendência branca
Diagnostic tests
1st tests to order
- rastreamento neonatal para transtornos metabólicos
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
Treatment algorithm
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
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.
Differentials
- Defeitos congênitos da tetraidrobiopterina ou da sua reciclagem
- Disfunção hepática
- Prematuridade extrema
More DifferentialsGuidelines
- Phenylalanine hydroxylase deficiency diagnosis and management
- PKU nutrition management guidelines
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