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Nevez G, Guillaud-Saumur T, Cros P, Papon N, Vallet S, Quinio D, Minoui-Tran A, Pilorgé L, de Parscau L, Sizun J, Ochoa TJ, Bustamante B, Ponce C, Vargas SL, Le Gal S. Pneumocystis primary infection in infancy: Additional French data and review of the literature. Med Mycol 2020; 58:163-171. [PMID: 31127850 PMCID: PMC7107579 DOI: 10.1093/mmy/myz040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/03/2019] [Accepted: 04/05/2019] [Indexed: 11/12/2022] Open
Abstract
Data on features of Pneumocystis primary infection in infancy are still fragmented. To study Pneumocystis primary infection, 192 infants who were monitored for acute pulmonary disease or fever over a 40-month period were retrospectively investigated. P. jirovecii detection on archival nasopharyngeal aspirates was performed using a qPCR assay. Factors associated with P. jirovecii were assessed using univariate and multivariate analyses. P. jirovecii genotypes in infants and a control group of adults contemporaneously diagnosed with Pneumocystis pneumonia were identified using unilocus, bilocus, and multilocus sequence typing (MLST). P. jirovecii was detected in 35 infants (18.2%). The univariate analysis pointed out four factors: viral infection (P = .035, OR [IC 95], 2.2 [1.1–4.7]), lower respiratory tract infection (P = .032, OR [IC 95], 2.5 [1.1–5.9]), absence of hospital discharge after birth (P = .003, OR (IC 95), 0.1 (0.02–0.5]), and the 63–189-day group (P < .001, OR [IC 95], 42.2 [5.4–332]). The multivariate analysis confirmed these two latter factors (P = .02, OR [IC 95], 0.1 [0.02–0.72]; P = .005, OR [IC 95], 11.5 [2.1–63.5]). Thus, P. jirovecii acquisition mostly takes place in the community. A comparison of these data with those of previously published studies showed that median and interquartile range of positive-infant ages were close to those observed in Chile, Denmark, and Peru, highlighting similar characteristics. Common unilocus or bilocus genotypes were identified in infants and adults, whereas no MLST genotypes were shared. Therefore, a common reservoir made up of infected infants and adults is still hypothetical. Finally, primary infection is a worldwide phenomenon occurring at the same time in childhood regardless of geographical location, rather than an incidental event.
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Affiliation(s)
- Gilles Nevez
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Angers-Brest, Université de Bretagne-Loire, France.,Laboratoire de Mycologie et Parasitologie, CHRU de Brest, Brest, France
| | - Thibaud Guillaud-Saumur
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Angers-Brest, Université de Bretagne-Loire, France.,Laboratoire de Mycologie et Parasitologie, CHRU de Brest, Brest, France
| | - Pierrick Cros
- Département de Pédiatrie, CHRU de Brest, Brest, France
| | - Nicolas Papon
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Angers-Brest, Université de Bretagne-Loire, France
| | - Sophie Vallet
- Laboratoire de Virologie, CHRU de Brest, Brest, France.,UMR INSERM U 1078, Université de Bretagne-Loire, Brest, France
| | - Dorothée Quinio
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Angers-Brest, Université de Bretagne-Loire, France.,Laboratoire de Mycologie et Parasitologie, CHRU de Brest, Brest, France
| | | | - Léa Pilorgé
- Laboratoire de Virologie, CHRU de Brest, Brest, France
| | | | - Jacques Sizun
- Département de Pédiatrie, CHRU de Brest, Brest, France
| | - Theresa J Ochoa
- Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Beatriz Bustamante
- Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carolina Ponce
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago
| | - Sergio L Vargas
- Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago
| | - Solène Le Gal
- Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP) EA 3142, Angers-Brest, Université de Bretagne-Loire, France.,Laboratoire de Mycologie et Parasitologie, CHRU de Brest, Brest, France
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Bérody S, Heidet L, Gribouval O, Harambat J, Niaudet P, Baudouin V, Bacchetta J, Boudaillez B, Dehennault M, de Parscau L, Dunand O, Flodrops H, Fila M, Garnier A, Louillet F, Macher MA, May A, Merieau E, Monceaux F, Pietrement C, Rousset-Rouvière C, Roussey G, Taque S, Tenenbaum J, Ulinski T, Vieux R, Zaloszyc A, Morinière V, Salomon R, Boyer O. Treatment and outcome of congenital nephrotic syndrome. Nephrol Dial Transplant 2018; 34:458-467. [DOI: 10.1093/ndt/gfy015] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 12/24/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sandra Bérody
- Hôpital Necker-Enfants malades, Néphrologie pédiatrique, Assistance Publique des Hôpitaux de Paris, Université Paris Descartes-Sorbonne Paris-Cité, Paris, France
| | - Laurence Heidet
- Hôpital Necker-Enfants malades, Néphrologie pédiatrique, Assistance Publique des Hôpitaux de Paris, Université Paris Descartes-Sorbonne Paris-Cité, Paris, France
- Centre de référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, Hôpital Necker-Enfants Malades, Paris, France
- Inserm U1163, Imagine Institute, Paris, France
| | | | - Jérome Harambat
- Centre Hospitalier Universitaire de Bordeaux, Néphrologie pédiatrique, Bordeaux, France
| | - Patrick Niaudet
- Hôpital Necker-Enfants malades, Néphrologie pédiatrique, Assistance Publique des Hôpitaux de Paris, Université Paris Descartes-Sorbonne Paris-Cité, Paris, France
- Centre de référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, Hôpital Necker-Enfants Malades, Paris, France
- Inserm U1163, Imagine Institute, Paris, France
| | - Veronique Baudouin
- Centre de référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, Hôpital Necker-Enfants Malades, Paris, France
- Hôpital Universitaire Robert Debré, Néphrologie pédiatrique, Paris, France
| | | | | | | | | | - Olivier Dunand
- CHU Felix Guyon, Pédiatrie, Saint-Denis, La Reunion, France
| | | | - Marc Fila
- Centre Hospitalier Regional Universitaire de Montpellier, Néphrologie pédiatrique, Montpellier, France
| | - Arnaud Garnier
- Centre Hospitalier Universitaire de Toulouse, Néphrologie pédiatrique, Toulouse, France
| | | | - Marie-Alice Macher
- Hôpital Universitaire Robert Debré, Néphrologie pédiatrique, Paris, France
| | - Adrien May
- Centre Hospitalier Sud Francilien, Pédiatrie, Corbeil-Essonnes, France
| | | | | | | | | | - Gwenaëlle Roussey
- Centre Hospitalier Universitaire de Nantes, Néphrologie pédiatrique, Nantes, France
| | - Sophie Taque
- Centre Hospitalier Universitaire de Rennes, Pédiatrie, Rennes, France
| | - Julie Tenenbaum
- Centre Hospitalier Regional Universitaire de Montpellier, Néphrologie pédiatrique, Montpellier, France
| | - Tim Ulinski
- Centre de référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, Hôpital Necker-Enfants Malades, Paris, France
- Hôpital Armand-Trousseau, Néphrologie pédiatrique, Paris, France
| | - Rachel Vieux
- Centre Hospitalier Universitaire de Nancy, Pédiatrie, Nancy, France
| | | | | | - Rémi Salomon
- Hôpital Necker-Enfants malades, Néphrologie pédiatrique, Assistance Publique des Hôpitaux de Paris, Université Paris Descartes-Sorbonne Paris-Cité, Paris, France
- Centre de référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, Hôpital Necker-Enfants Malades, Paris, France
- Inserm U1163, Imagine Institute, Paris, France
| | - Olivia Boyer
- Hôpital Necker-Enfants malades, Néphrologie pédiatrique, Assistance Publique des Hôpitaux de Paris, Université Paris Descartes-Sorbonne Paris-Cité, Paris, France
- Centre de référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA), Centre de référence du syndrome néphrotique idiopathique de l'enfant et de l'adulte, Hôpital Necker-Enfants Malades, Paris, France
- Inserm U1163, Imagine Institute, Paris, France
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Jeannesson-Thivisol E, Feillet F, Chéry C, Perrin P, Battaglia-Hsu SF, Herbeth B, Cano A, Barth M, Fouilhoux A, Mention K, Labarthe F, Arnoux JB, Maillot F, Lenaerts C, Dumesnil C, Wagner K, Terral D, Broué P, de Parscau L, Gay C, Kuster A, Bédu A, Besson G, Lamireau D, Odent S, Masurel A, Guéant JL, Namour F. Genotype-phenotype associations in French patients with phenylketonuria and importance of genotype for full assessment of tetrahydrobiopterin responsiveness. Orphanet J Rare Dis 2015; 10:158. [PMID: 26666653 PMCID: PMC5024853 DOI: 10.1186/s13023-015-0375-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 12/08/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mutations in Phenylalanine Hydroxylase (PAH) gene cause phenylketonuria. Sapropterin (BH4), the enzyme cofactor, is an important therapeutical strategy in phenylketonuria. However, PAH is a highly polymorphic gene and it is difficult to identify BH4-responsive genotypes. We seek here to improve prediction of BH4-responsiveness through comparison of genotypes, BH4-loading test, predictions of responsiveness according to the literature and types and locations of mutations. METHODS A total of 364 French patients among which, 9 % had mild hyperphenylalaninemia, 17.7 % mild phenylketonuria and 73.1 % classical phenylketonuria, benefited from a 24-hour BH4-loading test and had the PAH gene sequenced and analyzed by Multiplex Ligation Probe Amplification. RESULTS Overall, 31.6 % of patients were BH4-responsive. The number of different mutations found was 127, including 26 new mutations. The mutations c.434A > T, c.500A > T, c.529G > C, c.1045 T > G and c.1196 T > C were newly classified as being BH4-responsive. We identified 261 genotypes, among which 46 were newly recognized as being BH4-responsive. Even though patients carry 2 responsive alleles, BH4-responsiveness cannot be predicted with certainty unless they present mild hyperphenylalaninemia. BH4-responsiveness cannot be predicted in patients carrying one responsive mutation only. In general, the milder the phenotype is, the stronger the BH4-response is. Almost exclusively missense mutations, particularly in exons 12, 11 and 8, are associated with BH4-responsiveness and any other type of mutation predicts a negative response. CONCLUSIONS This study is the first of its kind, in a French population, to identify the phenotype associated with several combinations of PAH mutations. As others, it highlights the necessity of performing simultaneously BH4 loading test and molecular analysis in monitoring phenylketonuria patients.
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Affiliation(s)
- Elise Jeannesson-Thivisol
- Reference Center for Inherited Metabolic Diseases, University Hospital of Nancy, 9 ave Forêt de Haye, BP 184, 54511, Vandoeuvre-lès-Nancy, France
- INSERM U954, Department of Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 9 ave Forêt de Haye, BP 184, 54511, Vandoeuvre-lès-Nancy, France
| | - François Feillet
- Reference Center for Inherited Metabolic Diseases, University Hospital of Nancy, 9 ave Forêt de Haye, BP 184, 54511, Vandoeuvre-lès-Nancy, France
- INSERM U954, Department of Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 9 ave Forêt de Haye, BP 184, 54511, Vandoeuvre-lès-Nancy, France
| | - Céline Chéry
- Reference Center for Inherited Metabolic Diseases, University Hospital of Nancy, 9 ave Forêt de Haye, BP 184, 54511, Vandoeuvre-lès-Nancy, France
- INSERM U954, Department of Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 9 ave Forêt de Haye, BP 184, 54511, Vandoeuvre-lès-Nancy, France
| | - Pascal Perrin
- Reference Center for Inherited Metabolic Diseases, University Hospital of Nancy, 9 ave Forêt de Haye, BP 184, 54511, Vandoeuvre-lès-Nancy, France
- INSERM U954, Department of Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 9 ave Forêt de Haye, BP 184, 54511, Vandoeuvre-lès-Nancy, France
| | - Shyue-Fang Battaglia-Hsu
- Reference Center for Inherited Metabolic Diseases, University Hospital of Nancy, 9 ave Forêt de Haye, BP 184, 54511, Vandoeuvre-lès-Nancy, France
- INSERM U954, Department of Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 9 ave Forêt de Haye, BP 184, 54511, Vandoeuvre-lès-Nancy, France
| | - Bernard Herbeth
- Reference Center for Inherited Metabolic Diseases, University Hospital of Nancy, 9 ave Forêt de Haye, BP 184, 54511, Vandoeuvre-lès-Nancy, France
- INSERM U954, Department of Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 9 ave Forêt de Haye, BP 184, 54511, Vandoeuvre-lès-Nancy, France
| | - Aline Cano
- Reference Center for Inherited Metabolic Diseases, Timone Hospital, Marseille, France
| | - Magalie Barth
- Department of Biochemistry and Genetics, Angers University Hospital, Angers, France
| | - Alain Fouilhoux
- Reference Center for Inherited Metabolic Diseases, Hospices Civils de Lyon, Bron, France
| | - Karine Mention
- Reference Center for Inherited Metabolic Diseases, Jeanne de Flandres Hospital, Lille, France
| | - François Labarthe
- Department of Pediatric Medicine, Clocheville Hospital, Tours, France
| | - Jean-Baptiste Arnoux
- Reference Center for Inherited Metabolic Diseases, Necker-Enfants Malades Hospital, Paris, France
| | - François Maillot
- Department of Internal Medicine, Tours University Hospital, Tours, France
| | | | - Cécile Dumesnil
- Pediatric Hematology and Oncology, Rouen University-Hospital, Rouen, France
| | - Kathy Wagner
- Department of Pediatrics, Lenval Hospital, Nice, France
| | - Daniel Terral
- Department of Pediatrics, Hotel-Dieu Hospital, Clermont-Ferrand, France
| | - Pierre Broué
- Department of Pediatric Hepatology and Metabolic Diseases, Children Hospital, Toulouse, France
| | | | - Claire Gay
- Department of Pediatrics, Saint-Etienne University-Hospital, Saint-Etienne, France
| | - Alice Kuster
- Pediatric Department, Nantes University Hospital, Nantes, France
| | - Antoine Bédu
- Neonatology Department, Mère-Enfant Hospital, Limoges, France
| | - Gérard Besson
- Department of Neurology, University Hospital of Grenoble, Grenoble, France
| | - Delphine Lamireau
- Department of Pediatrics, Pellegrin-Enfants Hospital, Bordeaux, France
| | - Sylvie Odent
- Department of Clinical Genetics, Rennes University Hospital, Rennes, France
| | - Alice Masurel
- Department of Medical Genetics, Dijon University-Hospital, Dijon, France
| | - Jean-Louis Guéant
- Reference Center for Inherited Metabolic Diseases, University Hospital of Nancy, 9 ave Forêt de Haye, BP 184, 54511, Vandoeuvre-lès-Nancy, France
- INSERM U954, Department of Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 9 ave Forêt de Haye, BP 184, 54511, Vandoeuvre-lès-Nancy, France
| | - Fares Namour
- Reference Center for Inherited Metabolic Diseases, University Hospital of Nancy, 9 ave Forêt de Haye, BP 184, 54511, Vandoeuvre-lès-Nancy, France.
- INSERM U954, Department of Nutrition-Genetics-Environmental Risk Exposure, University of Lorraine, 9 ave Forêt de Haye, BP 184, 54511, Vandoeuvre-lès-Nancy, France.
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Teissier R, Nowak E, Assoun M, Mention K, Cano A, Fouilhoux A, Feillet F, Ogier H, Oger E, de Parscau L. Maternal phenylketonuria: low phenylalaninemia might increase the risk of intra uterine growth retardation. J Inherit Metab Dis 2012; 35:993-9. [PMID: 22669364 DOI: 10.1007/s10545-012-9491-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 04/13/2012] [Accepted: 04/16/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Malformations and mental retardation in the offspring of women with Phenylketonuria (PKU) can be prevented by maintaining maternal blood Phenylalanine (PHE) within a target range (120-300 μmol/L) through a PHE-restricted diet. In a former French study, a high and unexpected proportion of intra uterine growth retardation (IUGR) has been reported. Guidelines have been proposed to all French centres caring for maternal PKU since 2002. OBJECTIVE To confirm IUGR and investigate its causes. The other goals were to assess the follow-up of these pregnancies based on the new guidelines and the pertinence of these recommendations. DESIGN Clinical, biological and ultrasound data of all pregnancies in PKU women in France, from 2002 to 2007 were retrospectively analyzed. RESULTS Data from 115 pregnancies in 86 women with PKU were collected. Ninety percent of women had been informed of the risk of maternal PKU in the absence of a strict diet during pregnancy, 88 % of women had started a diet before conception, and 45 % of infants were born small for gestational age (birth length and/or weight ≤-2 SD). PHE intakes were lower in the group with IUGR from the fifth to the eighth month of pregnancy and duration of time spent at <120 μmol/L during pregnancy was associated with a higher risk of IUGR. CONCLUSION Hyperphenylalaninemia (HPA) is not the only risk factor for IUGR; PHE lower than 120 μmol/L could also be associated with the IUGR occurrence. Even if the monitoring of these pregnancies has been improved since the initiation of guidelines, we would like to stress on the importance of the dietary aspect of the disease.
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Affiliation(s)
- Raphaël Teissier
- Department of Pediatrics, Brest University Hospital, CHRU Morvan, 2 avenue Foch, 29200, Brest, France.
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Leuret O, Barth M, Kuster A, Eyer D, de Parscau L, Odent S, Gilbert-Dussardier B, Feillet F, Labarthe F. Efficacy and safety of BH4 before the age of 4 years in patients with mild phenylketonuria. J Inherit Metab Dis 2012; 35:975-81. [PMID: 22388642 DOI: 10.1007/s10545-012-9464-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Revised: 02/05/2012] [Accepted: 02/07/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND Sapropterin dihydrochloride, an EMEA-approved synthetic formulation of BH4, has been available in Europe since 2009 for PKU patients older than 4 years, but its use with younger children is allowed in France based on an expert recommendation. We report the cases of 15 patients treated under the age of 4 years and demonstrate the safety and efficacy of this treatment for patients in this age group. PATIENTS AND METHOD We report the use of BH4 in 15 PKU patients treated before the age of 4 years. RESULTS Fifteen patients were enrolled in this retrospective study. Mean phenylalaninemia at diagnosis was 542 ± 164 μM and all patients had mild PKU (maximal phenylalaninemia: 600-1200 μM). BH4 responsiveness was assessed using a 24-hour BH4 loading test (20 mg/kg), performed during the neonatal period (n = 11) or before 18 months of age (n = 4). During the test, these patients exhibited an 80 ± 12% decrease in phenylalaninemia. Long-term BH4 therapy was initiated during the neonatal period (n = 7) or at the age of 13 ± 12 months (n = 8). The median duration of treatment was 23 months [min 7; max 80]. BH4 therapy drastically improved dietary phenylalanine tolerance (456 ± 181 vs 1683 ± 627 mg/day, p < 0.0001) and allowed a phenylalanine-free amino acid mixture to be discontinued or not introduced in 14 patients. Additionally, in the eight patients treated after a few months of diet therapy, BH4 treatment significantly decreased mean phenylalaninemia (352 ± 85 vs 254 ± 64 μM, p < 0.05), raised the percentage of phenylalaninemia tests within therapeutic targets [120-300 μM] (35 ± 25 vs 64 ± 16%, p < 0.05), and reduced phenylalaninemia variance (130 ± 21 vs 93 ± 27 μM, p < 0.05). No side effects were reported. CONCLUSION BH4-therapy is efficient and safe before the age of 4 years in mild PKU, BH4-responsive patients.
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Affiliation(s)
- Oriane Leuret
- Médecine Pédiatrique & INSERM U921, CHRU de Tours, Université François Rabelais, Tours, France
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Abstract
Hyperphenylalaninemia (HPA) is the most frequently inherited disorder of amino acid metabolism (prevalence 1:10,000). In France, a nationwide neonatal screening was organized in 1978 to control its efficacy and patient follow-up. Phenylketonuria (PKU) was diagnosed in 81.6% of screened patients, the remaining affected with either non-PKU HPA (17.2%) or with cofactor deficiency (1.1%). French guidelines were established to specify the minimal diagnosis procedures and optimal treatment of patients. A low-phenylalanine diet must be started within the first days of life for all newborns whose blood phenylalanine levels are above 10 mg/dL (600 micromol/L). The dietary control must keep the phenylalanine levels between 2 and 5 mg/dL (120 and 300 micromol/L) until 10 y of age. Thereafter, a progressive and controlled relaxation of the diet is allowed, keeping levels below 15 mg/dL until the end of adolescence and below 20 mg/dL (1200 micromol/L) in adulthood. A lifelong follow-up is recommended for PKU women to prevent for maternal PKU.
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Affiliation(s)
- Hélène Ogier de Baulny
- Service de Neurologie et Maladies Métaboliques, Hôpital R. Debré, Assistance Publique des Hôpitaux de Paris, 75019 Paris, France.
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de Parscau L. [Psychomotor development of infants and children. Normal and pathologic aspects (sleep, digestion, sphincter control, psychomotor, language, intelligence). The early role of the mother-child relationship and its importance in learning disorders]. Rev Prat 2002; 52:319-26. [PMID: 11925724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Loïc de Parscau
- Service de pédiatrie, centre hospitalier régional, universitaire de Brest, hôpital Morvan, 29609 Brest
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