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  • 1
    ISSN: 1432-1076
    Keywords: EEG ; Phenylketonuria ; Dietary treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 126 early treated PKU patients (type I and type II) a close EEG follow up was performed from birth up to 6 years of age. A total of 1465 EEGs were performed before and after onset of dietary treatment and on 11 more subsequent occasions. The composition of the background activity was normal up to 6 years when only a small number of the children (19) showed no dominant alpha activity. The frequency of epileptiform activity of generalised as well as focal type was low in the first 2 years of life, but afterwards slightly enhanced in comparison to normal control groups. Other findings like generalised theta paroxysms or focal slow waves were rarely observed. Under a standardised protein load at 6 months (52 patients) and at 5 years of age (42 patients) a moderate generalised slowing of the background activity but no other abnormalities were noted.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 149 (1990), S. 39-44 
    ISSN: 1432-1076
    Keywords: Phenylketonuria ; Phenylalanine ; Information processing ; Sustained attention ; Intelligence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A series of information processing tasks was administered to 22 PKU children aged 8.5 years who had been under dietary treatment since birth as well as to 20 controls of the same age. This contribution presents the results of two tasks from this series: a continuous performance task and a calculation task. The continuous performance task revealed a sustained attention deficit in the PKU group. In the calculation task the PKU children were slower than the controls and this difference increased with task difficulty. When the PKU sample was divided in two groups (above and below the median value of the concurrent plasma Phe level), the high Phe level group performed much worse in comparison to the low Phe level group. The latter group actually matched performance level of the controls. This could be observed for both tasks. The serum Phe level, assessed since birth over 6 month periods, correlated highly with task performance. As regards sustained attention, the Phe level measured during the 2 years preceeding test administration appeared to be an even better predictor for task performance than the concurrent Phe level, a finding which seems to underline the chronic effect of Phe on basic attention mechanisms. The results so far seem to stress the value of well-controlled dietary restrictions.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 149 (1990), S. 13-16 
    ISSN: 1432-1076
    Keywords: Phenylketonuria ; Phenylalanine intake ; Diet control ; Compliance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The daily Phe intakes of normally growing 1- to 6-year-old treated PKU patients were evaluated. The children received protein in amounts that varied from 2.26±0.47 g/kg body weight per day (mean±SD) at the age of 6 to 1.81±0.35 at the age of 72 months. Mean Phe intakes declining from 34±7 at the age of 6 months to 15±5 mg/kg body weight per day at the age of 72 months were required to maintain mean median plasma Phe levels around 6.0 mg/dl.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1076
    Keywords: Phenylketonuria ; Phenylpyruvic acid ; Phenyllactic acid ; Protein loading test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In the course of the collaborative study of children treated for PKU, urine samples from a total of 165 patients were analysed at six different times: in the newborn period before onset of therapy, after beginning of dietary management, during and immediately after a protein loading test at 6 months of age. In 95.9% of newborns with elevated Phe levels in plasma, metabolites of this amino acid as well as of Tyr could be detected. Of all metabolites phenylpyruvate always showed the highest concentration, followed by phenyllactate and o-hydroxy-phenylacetate. During the protein loading test an increase of the same metabolites occured. At the age of 6 months the percentage of p-hydroxylated compounds related to the sum of all metabolites was lower than in the newborn period. Comparing the results of urine analyses at 6 months of age after the protein loading tests with the classification of HPA into the reaction types I–III, it can be clearly stated that patients with the milder forms II and III have already lower levels of Phe metabolites in urine before onset of therapy compared to the reaction type I. In retrospect 52% of the newborns could therefore be classified as reaction type I even before beginning of dietary management. The analysis of urinary Phe metabolites before the onset of therapy therefore provides sufficient information about the reaction type.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 149 (1990), S. 34-38 
    ISSN: 1432-1076
    Keywords: Phenylketonuria ; Intelligence quotient ; Dietary control ; Longitudinal study ; Psychometric test results
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cognitive development of early treated PKU children (132) was investigated by intelligence tests, tests for visual perception, motor and language development. Deviations from test norms occurred at 5 years of age concerning performance IQ, mathematical thinking, and visual perception. With the exception of mathematical thinking, “normal” results were obtained at the age of 6 years. Correlation with levels of plasma Phe revealed a relation between qualitiy of dietary control and performance IQ. Results are discussed in light of methodological aspects and with respect to treatment consequence.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 149 (1990), S. 5-12 
    ISSN: 1432-1076
    Keywords: Collaborative study ; PKU ; study design
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A West German multicentre study (eight centres) of PKU was designed in 1976. The subjects of the study are the differential diagnosis, factors influencing the therapeutic outcome, and the extension of dietary therapy into adolescence. Between 1978 and 1984, 165 patients were enrolled, of whom 38 were of non-German nationality. The educational and occupational status of the West German parents were comparable to the population of the Federal Republic of Germany. In the central data bank located at the University Childrens Hospital in Heidelberg, data from recurrent medical examinations and from biochemistry, dietetics, neurology, psychometry and demography were collected. The differential diagnosis of the elevated plasma Phe level in the newborn period resulted in the detection of 2 patients with a PTPS-deficiency, and of 163 with an apo-enzyme defect. Depending upon the magnitude of the Phe levels during the first weeks of life, preliminary treatment groups were formed. They were revised at the age of 6 months with a protein challenge. The levels of Phe during the protein challenge resulted in three types of response. Of these, type III can apparently forgo dietary restrictions resulting in plasma Phe concentrations of around 10 mg/dl. Preliminary results of the whole study are now presented.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1076
    Keywords: PKU ; Phenylalanine hydroxylase ; Deuterated phenylalanine ; Psychointellectual outcome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 20 patients with PAH deficiency, in vivo RA was determined by an intravenous deuterated Phe load. Sixteen patients had RAs of less than 0.4% of normal, 3a clearly detectable activity between 0.8 and 1.4% of normal. Long-term Phe tolerance as measured by the distribution of plasma Phe levels in categories (0–3.9, 4.0–9.9, 10–15.9 and over 16 mg/dl) was much improved in patients with RAs greater than 0.8%. There was a negative correlation between RA and number of plasma Phe levels 〉16 mg/dl. Relationship between full scale IQ at the age of 9 years and dietary control showed a positive correlation between IQ and the number of Phe levels between 0–10 mg/dl (k=.50p〈0.05). Highest (negative) correlation (k=−0.67p〈0.007) was found between full scale IQ and the number of Phe values 〉16 mg/dl as measured over 9 years. On the one hand detectable RA of PAH reduces the risk of high Phe levels and thus may also reduce the risk of brain damage in untreated or suboptimally treated patients with PAH. On the other hand enzyme measurement of PAH is no predictive parameter for Phe tolerance in an individual patient since RA may be very similar in phenylketonuric/hyperphenylalaninaemic patients. For practical purposes the oral protein loading test at the age of 6 months will give the most reliable results for differential diagnosis of PAH deficiency.
    Type of Medium: Electronic Resource
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