Susan A. Berry MD, Christine Brown MS, Mitzie Grant PhD, Carol L. Greene MD, Elaina Jurecki MS, RD, Jean Koch BA, Kathryn Moseley MS, RD, Ruth Suter MBA, RD, Sandra C. van Calcar PhD RD, Judy Wiles BsocSc & Stephen Cederbaum MD
Genetics in Medicine (2013) | doi:10.1038/gim.2013.10
Received 20 November 2012 Accepted 15 January 2013 Published online 07 March 2013
Fifty years after the implementation of universal newborn screening programs for phenylketonuria, the first disease identified through newborn screening and considered a success story of newborn screening, a cohort of adults with phenylketonuria treated from birth provides valuable information about effects of long-term treatment for inborn errors of metabolism in general, and phenylketonuria specifically. For phenylketonuria, newborn screening allows early implementation of the phenylalanine-restricted diet, eliminating the severe neurocognitive and neuromotor impairment associated with untreated phenylketonuria. However, executive function impairments and psychiatric problems are frequently reported even for those treated early and continuously with the phenylalanine-restricted diet alone. Moreover, a large percentage of adults with phenylketonuria are reported as lost to follow-up by metabolic clinics. While a group of experts identified by the National Institutes of Health convenes to update treatment guidelines for phenylketonuria, we explore individual patient, social, and economic factors preventing >70% of adult phenylketonuria patients in the United States from accessing treatment. As more conditions are identified through newborn screening, factors affecting access to treatment grow in importance, and we must continue to be vigilant in assessing and addressing factors that affect patient treatment outcomes and not just celebrate amelioration of the most severe manifestations of disease.
Genet Med advance online publication 7 March 2013
Access; newborn screening; phenylketonuria; PKU; treatment
To download article, visit http://www.nature.com/gim/journal/vaop/ncurrent/pdf/gim201310a.pdf