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Órgano Oficial del Instituto Nacional de Pediatría
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2012, Number 6

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Acta Pediatr Mex 2012; 33 (6)

Care model for patients with phenylketonuria (PKU) in Argentina

Chiesa A, Fraga C, Prieto L, Pardo ML
Full text How to cite this article

Language: Spanish
References: 8
Page: 308-310
PDF size: 70.97 Kb.


Key words:

Hyperphenylalaninemia, PKU, nutritional treatment, tyrosine, neurological symptoms.

ABSTRACT

Argentinean hyperphenylalaninemia newborn screening program was initiated by the Infantile Endocrinology Foundation in 1985. At the present it coexists with other several public health programs. To date phenylketonuria (PKU) incidence is 1:12,000 living newborns out of 1,300,000 subjects tested.
Nutritional treatment consists of a diet restricted in phenylanine (Phe) and free of animal food, it is started in all children whose serum Phe levels are above 6 mg/dL, low tyrosine (Tyr) concentration, and a Phe to Tyr ratio ›3, although patients between 2 to 6 mg/dL are closely followed. Periodic blood Phe quantification and dietetic instructions to the patient are required in order to keep Phe levels in a safe range that preserves nervous system maturing, and prevention of mental retardation which is inherent to non-treated disease
Educational activities constitute the core of the teamwork; they are destined to achieve the best psycho-social integration of the patient to society. Patients’ mothers are trained to follow dietetic quantities of Phe following the “Practical guidance for phenylketonuric patients’ nutrition”. Diet compliance is a complex process which should be evaluated in individual and familiar context in order to identify the need for extra medical support; adolescents are the most vulnerable age population.
It has been noted that late diagnosed patients who were given the adequate proposed treatment improved in terms of neurological symptoms, behavioral issues as well as in their potential for rehabilitation.


REFERENCES

  1. Chiesa A, Gruñeiro de Papendieck L, Prieto L, Valle G. Pesquisa neonatal de fenilcetonuria e hiperfenilalaninemias: diagnóstico y seguimiento. Arch Argent Pediatr 1994;92:338-43.

  2. Gruñeiro de Papendieck L, Chiesa A, Prieto L, Kesselman A, Ruarte G, Goso S, Nadal MA, Bergadá C. Pesquisa neonatal de hipotiroidismo congénito y fenilcetonuria: 10 años de experiencia de la Fundación de Endocrinología Infantil en la República Argentina. Bol Acad Nac Med B Aires 1996;(supl):283-9.

  3. Gruñeiro–Papendieck L, Chiesa A, Prieto L. Prevención de la Discapacidad Mental y Física que originan Enfermedades Genéticas y Metabólicas inaparentes al nacimiento: Experiencia Argentina. Documentos/98. Madrid – España: Ed. Real Patronato de Prevención y de Atención de Personas con Minusvalía; 1998.

  4. Recopilación de casos de pacientes con fenilcetonuria no tratada que han iniciado el tratamiento dietético. Ana Chiesa. Fundación de Endocrinología Infantil SHS International. Enero 2001.

  5. Chiesa A, Keselman A, Fraga C, Pardo ML. Guía dietoterápica para la alimentación de niños fenilcetonúricos FEI 2007.

  6. Scriver C, Levy H, Donlon J. Hyperphenylalaninemia: Phenylalanine hydroxylase deficiency 2008 http://www.ommbid.com/ OMMBID/ theonline_metabolic_and_molecular_bases_of_inherited_ disease/b/abstract/part8/ch77.

  7. Recommendations on the dietary management of phenylketonuria. Report of Medical Research Council Working Party on Phenylketonuria Arch Dis Child 1993;68(3):426-7.

  8. MacDonald A, Gokmen-Ozel H, van Rijn M, Burgard P. The reality of dietary compliance in the management of phenylketonuria. J Inherit Metab Dis 2010;33:665-70.




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Acta Pediatr Mex. 2012;33