No abstract

Early diagnosis and treatment of phenylketonuria (PKU) in Poland was started in 1965, initially on a voluntary and then on a obligatory basis. Guthrie tests have been used for newborn screening. For confirmation of diagnosis changing with time methods of blood phenylalanine (Phe) and tyrosine estimation were used. In addition, Phe and its urinary metabolites were estimated. A total of 560 cases of classical PKU, 99 mild hyperphenylalaninaemia and six atypical PKU cases were detected. The age of confirmatory estimations was from the 1st to 3rd month, in some cases above 3 months. Pretreatment Phe levels ranged from 12.5 to 70.7 mg/dl. The diet was started on a hospital basis and continued at home, controlled with Guthrie tests with age dependent frequency. Periodical multidimensional controls allowed evaluation of physical and mental development, together with biochemical scores (Hb, RBC, total plasma protein, Phe and tyrosin). In some patients trace elements (copper, iron, zinc and selenium) were also determined. Physical development of treated patients was normal. Biochemical scores presented transient relatively low Hb and iron concentrations especially in the youngest patients. DQ/IQ scores correlated with dietary control and social environment. In adults (age 19-26 years) off diet, mean IQ was 97.2 +/- 15.5 in those with good dietary control and 81.0 +/- 13.8 in those poorly controlled during treatment. In adults the average level of education attained was various types of professional school. Some patients attended or graduated from university.

A total of 59 children from multiple pregnancy, aged from 18 months to 13 years, have all shown a mental development within or above normal limits.In 18 children there are reasons to suspect the presence of a CNS lesion, although the general mental level is good.The numerical concordance of intelligence quotients is not typical for MZ and DZ twins. In four cases there were marked qualitative differences despite IQ concordance.The behavior of twins in their home, preschool, and school environment, is determined by the separate nature of the relationship in which the twins live since birth.

Physical development scores and clinical condition were evaluated in 403 newborn of phenylketonuric (PKU) heterozygotes. No significant differences were found between this group and the progeny of women from a healthy population. Analysis of mental development scores in 82 non-PKU children age 3-14 years born to heterozygous mothers revealed normal values of psychometric tests.Phenylketonuria follows an autosomal-recessive pattern of inheritance. Partially deficient phenylalanine hydroxylase activity in phenylketonuric (PKU) heterozygotes is manifested by a moderately increased phenylalanine and decreased plasma tyrosine concentration. These abnormalities seem not to have any evident influence on their psychosomatic condition.The problem still to be discussed is the possible influence of disturbed amino acid equilibrium in body fluids on the intrauterine environment, and in consequence on the developing fetus. The aim of the present study was to evaluate the biological value of newborn offspring of PKU heterozygotes and mental developmerit of their healthy non-PKU children. A thorough anamnesis of gestation, the perinatal period and previous pregnancies was performed. MATERIALS AND METHODSThe analysed material includes the offspring of 200 obligatory phenylketonuric heterozygotes-mothers of PKU patients, ascertained by the newborn-screening programme and confirmed by verifying examinations-or patients diagnosed late with clinical symptoms of mental retardation. The total number of children born to these women was 403. Out of this number 238 (58.8%) were PKU patients and 167 (41.2 %) their healthy siblings.Biological maturity of newborn infants was evaluated on the basis of physical development parameters (body weight and length), by Apgar score or in cases of its absence by the evaluation of a paediatrician. The above parameters were analysed separately in PKU homozygotes and in their healthy siblings. The latter group was subdivided as far as possible into heterozygotes, and healthy homozygotes.Heterozygotes were identified with previously elaborated methods: Phe/Tyr and Phe2/Tyr scores based on a single determination of phenylalanine and tyrosine in blood serum and/or plasma, or by phenylalanine tolerance tests followed by a discrimatory analaysis of the results achieved (Duczyfiska et al., 1979(Duczyfiska et al., , 1980.Mental development was evaluated with the Brunet-Lezine psychometric test in children up to 3 years, with the Terman-Merrill test between 3 and 7 years and with the Wechsler Intelligence Scale for Children [WISCJ at school age. Attempts were made to separate heterozygotes from healthy homozygotes in these examinations. RESULTSThe total number of pregnancies analysed was 441; an average of 2.2 per mother. Of these, in 393 (89.1%) the course of pregnancy was regular and in 15 (3.4%) pathology of various types was found. In 35 cases (7.5 %) pregnancy was terminated by spontaneous abortion.Out of 441 pregnancies, 403 (91.4 %) were terminated by deliveries of alive and full-term newborns. The number...

In order to induce biologiial effects which are conditioned by IL-2, it is required to combine it w~th a s ecific membrane rece tor It may be assumed with great robabili that tRe IL-2R and its modPulation can be included in uncontroted grow% of leukemic cel!s. That is why it has been dec~ded to examine expression of N a t i o n a l R e s e a r c h I n s t i t u t e o f Mother a n d C h i l d , Warsaw, P o l a n d P a t i e n t R.M. -a boy t r e a t e d f o r p h e n y l k e t o n u r i a s i nc e t h e a g e of 3 weeks w i t h v e r y good d i e t a r y c o n t r o l . At a g e o f 5 months a d m i t t e d t o t h e c l i n i c b e c a u s e of psychomotor r e t a r d a t i o n . M u s c u l a r h y p o t o n i a and c o nv u l s i o n s were o b s e r v e d . D i a g n o s t i c e x a m i n a t i o n s f o r a t y p t f i a l PKUihBH l o a d i n g t e s t / w i t h e v i d e n t d e c r e a s e i n 4 end 8 h$ur/, a n a l y s i s o f b i o p t e r i n s i n t h e u r i n e / h i g h n e o p t e r i n , low b i o p t e r i n / p o i n t e d f o r t h e d e f e c t i n d i h y d r o b i o p t e r i n s y n t h e s i s . T r e a t m e n t w i t h Dopa + C a r b i d o p a and 5HT was i n t r o d u c e d and a t a g e o f 1 y e a r s u p p l e m e n t a t i o n w i t h BH a l l o w e d t o w i t h d r a w low phe d i e t and t o d e c r e a s e t 8 e d o s e s of d r u g s /Dopa between 7-9mg/kg bw., 5HT 3-5 and now 8,9mg/kg bw., BH 20-30mg/24h/.During 6 y e a r s o b s e r v a t i o n p e r i o d , a l f i o s t f u l l n o r m a l i s a t i o n i n psychomotor development was o b s e r v e d . DQ from t h e l o w e s t 4 9 i n c r e a s e d and s i n c e t h e a g e 3