Skip to main content
Log in

Strategy for the screening of tetrahydrobiopterin deficiency among hyperphenylalaninaemic patients: 15-Years experience

  • Published:
Journal of Inherited Metabolic Disease

Summary

Tetrahydrobiopterin deficiency in hyperphenylalaninaemic babies has to be rapidly recognized since the disease requires a specific treatment. Based on 15 years experience, we report on the evolution of a strategy for the detection of such patients. A total of 913 hyperphenylalaninaemic patients have been studied and 15 tetrahydrobiopterin deficiences have been detected or confirmed.

DHPR assay in dried blood samples and pteridine measurement in urine collected on filter paper combine convenient sampling and reliable tests for systematic investigation of hyperphenylalaninaemic patients for cofactor deficiency.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Arai, N., Narisawa, K., Hayakawa, H. and Tada, K. Hyperphenylalaninemia due to dihydropteridine reductase deficiency: diagnosis by enzyme assays on dried blood spots.Pediatrics 70 (1982) 426–430

    Google Scholar 

  • Armstrong, R. A., Sahota, A., Blair, J. A. and Cohen, B. E. Genetic analysis of partial dihydropteridine reductase deficiency in families with mental retardation.J. Inher. Metab. Dis. 9 (1986) 400–401

    Google Scholar 

  • Bartholomé, K. A new molecular defect in phenylketonuria.Lancet 2 (1974) 1580

    Google Scholar 

  • Blau, N., Dhondt, J. L., Guibaud, P., Kuster, T. and Curtius, H. C. New variant of hyperphenylalaninemia with excretion of 7-substituted pterins.Eur. J. Pediatr. 148 (1988) 176

    Google Scholar 

  • Curtius, H. C., Niederwieser, A., Viscontini, M., Otten, A., Schaub, J. Scheibenreiter, S. and Schmidt, H. Atypical phenylketonuria due to tetrahydrobiopterin deficiency. Diagnosis and treatment with tetrahydrobiopterin, dihydrobiopterin and sepiapterin.Clin. Chim. Acta 93 (1979) 251–262

    Google Scholar 

  • Danks, D. M. and Cotton, R. G. H. Early diagnosis of hyperphenylalaninemia due to tetrahydrobiopterin deficiency (malignant hyperphenylalaninemia).J. Pediatr. 96 (1980) 854–856

    Google Scholar 

  • Dhondt, J. L. Tetrahydrobiopterin deficiences. Preliminary analysis from an International Survey.J. Pediatr. 104 (1984) 501–508

    Google Scholar 

  • Dhondt, J. L. and Farriaux, J. P. Approche diagnostique des hyperphénylalaninémies.Arch. Fr. Pediatr. 38 (1981) 573–578

    Google Scholar 

  • Dhondt, J. L., Largillière, C., Ardouin, P., Farriaux, J. P. and Dautrevaux, M. Diagnosis of variants of hyperphenylalaninemia by determination of pterins in urine.Clin. Chim. Acta 110 (1981) 205–215

    Google Scholar 

  • Dhondt, J. L., Largillière, C. and Farriaux, J. P. Essai de classification des hyperphénylalaniniémies. A propos de 62 malades.Arch Fr. Pediatr. 40 (1983) 243–245

    Google Scholar 

  • Dhondt, J. L., Farriaux, J. P. and Hayte, J. M. Bilan de 6 années de dépistage des hyperphenylalaninénies par déficit en cofacteur.Arch. Fr. Pediatr. 43 (1986a) 785–789

    Google Scholar 

  • Dhondt, J. L., Largillière, C. and Farriaux, J. P. Hepatic phenylalanine hydroxylase and dietary tolerance in hyperphenylalaninaemic patients.J. Inher. Metab. Dis. 9, Suppl. 2 (1986b) 209–211

    Google Scholar 

  • Dhondt, J. L., Guibaud, P., Rolland, M. O., Dorche, C., André, S., Forzy, G. and Hayte, J.M. Neonatal hyperphenylalaninemia presumably caused by a new variant of biopterin synthetase deficiency.Eur. J. Pediatr. 147 (1988) 153–157

    Google Scholar 

  • Dhondt, J. L., Hayte, J. M. and Farriaux, J. P. Métabolisme des ptéridines non conjuguées chez l'homme.Pathol. Biol. 37 (1989) 282–295

    Google Scholar 

  • Dhondt, J. L., Tilmont, P., Ringel, J. and Farriaux, J. P. Pterins analysis in amniotic fluid for the prenatal diagnosis of GTP-cyclohydrolase deficiency.J. Inher. Metab. Dis. 13 (1990) 879–882

    Google Scholar 

  • Hsiao, K. J., Chiang, S. H., Liu, T. T. and Chiu, P. C. Tetrahydrobiopterin deficient phenylketonuria detected by neonatal screening in Taïwan. In: Curtius, H. C., Ghisla, S. and Blau, N. (eds.),Chemistry and Biology of Pteridines, W. de Gruyter, Berlin, 1990, pp. 402–407

    Google Scholar 

  • Kaufman, S. Differential diagnosis of variant forms of hyperphenylalaninemia.Pediatrics 65 (1980) 840–842

    Google Scholar 

  • Matalon, R. Current status of biopterin screening.J. Pediatr. 104 (1984) 579–581

    Google Scholar 

  • Milstien, S., Kaufman, S. and Summer, G. K. Hyperphenylalaninemia due to dihydropteridine reductase deficiency: Diagnosis by measurement of oxidized and reduced pterins in urine.Pediatrics 65 (1980) 806

    Google Scholar 

  • Narisawa, K., Hayakama, H., Arai, N., Matsuo, N., Tanaka, T., Naritomi, K. and Tada, K. Diagnosis of variant forms of hyperphenylalaninemia using filter paper spots of urine.J. Pediatr. 103 (1983) 577–579

    Google Scholar 

  • Naylor, E. W., Ennis, D. C. and Guetthoff, M. Eight years of screening for cofactor variant forms of phenylketonuria in North America. In Schmidt, B. J., Diament, A. J. and Loghin-Grosso, N. S. (eds.)Current Trends in Infant Screening, Excerpta Medica, Amsterdam, 1989, pp. 89–93

    Google Scholar 

  • Niederwieser, A., Shintaku, H. Leimbacher, W., Curtius, H. C., Hyanek, J., Zeman, J. and Endres, W. ‘Peripheral’ tetrahydrobiopterin deficiency with hyperphenylalaninemia due to incomplete 6-pyruvoyl tetrahydropterin synthase deficiency or heterozygosity.Eur. J. Pediatr. 146 (1987) 228–232

    Google Scholar 

  • Ozand, P. T, Hughes, H., Subramanyam, S. and Gascon, G. Biopterin-dependent PKU.Pediatr. Res. 25 (1989) 143A

    Google Scholar 

  • Ponzone, A., Ricca, V., Ferraris, S., Guardamagna, O., Bracco, G., Pagliardini, S., Levis, F., Giovannini, M., Riva, E. and Longhi, R. DHPR deficiency in Italy.J. Pediatr. 105 (1984) 1008

    Google Scholar 

  • Sahota, A., Blair, J. A., Barford, P. A., Leeming, R. J., Green, A. and Pollitt, R. J. Neonatal screening for dihydropteridine reductase deficiency.J. Inher. Metab. Dis. 8, Suppl. 2 (1985) 99–100

    Google Scholar 

  • Sahota, A., Leeming, R. J., Blair, J. A., Armstrong, R. A., Green, A. and Cohen, B. E. Partial dihydropteridine reductase deficiency and mental retardation.J. Inher. Metab. Dis. 9, Suppl. 2 (1986) 247–249

    Google Scholar 

  • Scriver, C. R., Kaufman, S. and Wo, S. L. C. The hyperphenylalaninemia. In: Scriver, C. R., Beaudet, A. L., Sly, W. S. and Valle, D. (eds).,The Metabolic Basis of Inherited Disease, McGraw-Hill, New York, 1989, pp. 495–546

    Google Scholar 

  • Smith, I. Atypical phenylketonuria accompanied by a severe progressive neurological illness unresponsive to dietary treatment.Arch. Dis. Child. 49 (1974) 245

    Google Scholar 

  • Surplice, I. M., Griffiths, P. D., Green, A. and Leeming, R. J. Dihydropteridine reductase activity in eluates from dried blood spots: automation of an assay for a national screening service.J. Inher. Metab. Dis. 13 (1990) 169–177

    Google Scholar 

  • Tavares de Almeida, I., Leandro, P. P., Portela, R., Cabral, A., Tasso, T., Eusébio, F., Blau, N. and Silveira, C. Atypical PKU due to BH4 deficiency: biochemical and clinical observations in two Portuguese patients.Proceedings of the 5th International Congress on Inborn Errors of Metabolism, Asilomar, USA, 1990

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dhondt, J.L. Strategy for the screening of tetrahydrobiopterin deficiency among hyperphenylalaninaemic patients: 15-Years experience. J Inherit Metab Dis 14, 117–127 (1991). https://doi.org/10.1007/BF01800581

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01800581

Keywords

Navigation