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The Molecular Bases of Phenylketonuria (PKU) in New South Wales, Australia: Mutation Profile and Correlation with Tetrahydrobiopterin (BH4) Responsiveness.
[phenylketonuria]
Phenylketonuria
(
PKU
)
is
an
autosomal
recessive
inborn
error
of
phenylalanine
metabolism
predominantly
caused
by
mutations
in
the
phenylalanine
hydroxylase
(
PAH
)
gene
.
Mutation
screening
was
carried
out
in
a
large
cohort
of
PKU
patients
from
New
South
Wales
,
Australia
.
Pathogenic
mutations
were
identified
in
99
%
of
the
alleles
screened
,
with
the
two
most
common
mutations
(
p
.
R
408
W
and
IVS
12
+
1
G
>
A
)
accounting
for
30
.
7
%
of
alleles
.
Most
individuals
were
compound
heterozygotes
for
previously
reported
mutations
,
but
four
novel
mutations
(
c
.
163
+
1
G
>
T
,
c
.
164
-
2
A
>
G
,
c
.
461
A
>
T
[
p
.
Y
154
F
]
,
and
c
.
510
-
1
G
>
A
)
and
a
novel
polymorphism
(
c
.
60
+
62
C
>
T
)
were
also
identified
.
A
number
of
patients
have
been
previously
tested
for
their
response
to
dietary
supplementation
of
tetrahydrobiopterin
(
BH
4
)
,
the
cofactor
of
PAH
.
Correlation
between
genotype
and
the
responses
revealed
that
although
genotype
is
a
major
determinant
of
BH
4
responsiveness
,
patients
with
the
same
genotype
may
also
show
disparate
responses
to
this
treatment
.
A
clinical
and
biochemical
evaluation
should
be
undertaken
to
determine
the
effectiveness
of
PKU
treatment
by
supplementation
of
BH
4
.
Diseases
Validation
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"large cohort"
symptom
adrenal incidentaloma
adrenomyeloneuropathy
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child syndrome
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inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
krabbe disease
oligodontia
pendred syndrome
phenylketonuria
thoracic outlet syndrome
waldenström macroglobulinemia
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