Skip to main content
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1981 May 23;282(6277):1680–1684. doi: 10.1136/bmj.282.6277.1680

Routine neonatal screening for phenylketonuria in the United Kingdom 1964-78. Medical Research Council Steering Committee for the MRC/DHSS Phenylketonuria Register.

PMCID: PMC1505602  PMID: 6786433

Abstract

From 1964 to 1968, despite a general policy of routine neonatal screening for phenylketonuria that was usually carried out using the Phenistix nappy test, half to one-quarter of all cases reported to the register had been missed in the screening programme and had not been detected before the age of 4 months. In about two-thirds of the "missed" cases no screening test had been carried out, and in one-third a urine test had been performed but had given a false-negative result. In 1968-9 the screening programme was reorganised according to recommendations made in a Government circular (HM (69) 72), which proposed that a specimen of blood should be obtained by heel prick from all newborn infants between the 6th and 14th day of life and be tested in a central laboratory for the presence of raised blood phenylalanine concentrations. The senior medical officers of the various regions were made responsible for ensuring that all infants were tested. By 1974 only 1 to 2% of surviving infants were not being tested for phenylketonuria in the neonatal period, and only five of the 357 cases born between 1974 and 1978 and notified to the register had been diagnosed after the age of 3 months.

Full text

PDF
1680

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blaskovics M. E., Schaeffler G. E., Hack S. Phenylalaninaemia. Differential diagnosis. Arch Dis Child. 1974 Nov;49(11):835–843. doi: 10.1136/adc.49.11.835. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bradley D. M. Screening for inherited metabolic disease in Wales using urine-impregnated filter paper. Arch Dis Child. 1975 Apr;50(4):264–268. doi: 10.1136/adc.50.4.264. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Buist N. R., Lis E. W., Tuerck J. M., Murphey W. H. Maternal phenylketonuria. Lancet. 1979 Sep 15;2(8142):589–589. doi: 10.1016/s0140-6736(79)91648-9. [DOI] [PubMed] [Google Scholar]
  4. Cahalane S. F. Phenylketonuria. Mass screening of newborns in Ireland. Arch Dis Child. 1968 Apr;43(228):141–144. doi: 10.1136/adc.43.228.141. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cockburn F., Farquhar J. W., Forfar J. O., Giles M., Robins S. P. Maternal hyperphenylalaninaemia in the normal and phenylketonuric mother and its influence on maternal plasma and fetal fluid amino acid concentrations. J Obstet Gynaecol Br Commonw. 1972 Aug;79(8):698–707. doi: 10.1111/j.1471-0528.1972.tb12903.x. [DOI] [PubMed] [Google Scholar]
  6. EFRON M. L., YOUNG D., MOSER H. W., MACCREADY R. A. A SIMPLE CHROMATOGRAPHIC SCREENING TEST FOR THE DETECTION OF DISORDERS OF AMINO ACID METABOLISM. A TECHNIC USING WHOLE BLOOD OR URINE COLLECTED ON FILTER PAPER. N Engl J Med. 1964 Jun 25;270:1378–1383. doi: 10.1056/NEJM196406252702602. [DOI] [PubMed] [Google Scholar]
  7. Fisch R. O., Doeden D., Lansky L. L., Anderson J. A. Maternal phenylketonuria. Detrimental effects on embryogenesis and fetal development. Am J Dis Child. 1969 Dec;118(6):847–858. [PubMed] [Google Scholar]
  8. GUTHRIE R., SUSI A. A SIMPLE PHENYLALANINE METHOD FOR DETECTING PHENYLKETONURIA IN LARGE POPULATIONS OF NEWBORN INFANTS. Pediatrics. 1963 Sep;32:338–343. [PubMed] [Google Scholar]
  9. Hudson F. P., Mordaunt V. L., Leahy I. Evaluation of treatment begun in first three mohs oflife in 184 cases of phenylketonuria. Arch Dis Child. 1970 Feb;45(239):5–12. doi: 10.1136/adc.45.239.5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hulse J. A., Grant D. B., Clayton B. E., Lilly P., Jackson D., Spracklan A., Edwards R. W., Nurse D. Population screening for congenital hypothyroidism. Br Med J. 1980 Mar 8;280(6215):675–678. doi: 10.1136/bmj.280.6215.675. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kaufman S., Berlow S., Summer G. K., Milstien S., Schulman J. D., Orloff S., Spielberg S., Pueschel S. Hyperphenylalaninemia due to a deficiency of biopterin. A variant form of phenylketonuria. N Engl J Med. 1978 Sep 28;299(13):673–679. doi: 10.1056/NEJM197809282991301. [DOI] [PubMed] [Google Scholar]
  12. Kaufman S., Holtzman N. A., Milstien S., Butler L. J., Krumholz A. Phenylketonuria due to a deficiency of dihydropteridine reductase. N Engl J Med. 1975 Oct 16;293(16):785–790. doi: 10.1056/NEJM197510162931601. [DOI] [PubMed] [Google Scholar]
  13. Komrower G. M., Sardharwalla I. B., Fowler B., Bridge C. The Manchester regional screening programme: a 10-year exercise in patient and family care. Br Med J. 1979 Sep 15;2(6191):635–638. doi: 10.1136/bmj.2.6191.635. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Langenbeck U., Behbehani A., Mench-Hoinowski A., Petersen M. Absence of a significant renal threshold for two aromatic acids in phenylketonuric children over two years of age. Eur J Pediatr. 1980 Aug;134(2):115–118. doi: 10.1007/BF01846027. [DOI] [PubMed] [Google Scholar]
  15. Rattenbury J. M., Brown J. K. Loophole in U.K. screening programme for P.K.U. Lancet. 1978 Aug 26;2(8087):482–483. doi: 10.1016/s0140-6736(78)91498-8. [DOI] [PubMed] [Google Scholar]
  16. SCRIVER C. R., DAVIES E., CULLEN A. M. APPLICATION OF A SIMPLE MICROMETHOD TO THE SCREENING OF PLASMA FOR A VARIETY OF AMINOACIDOPATHIES. Lancet. 1964 Aug 1;2(7353):230–232. doi: 10.1016/s0140-6736(64)90183-7. [DOI] [PubMed] [Google Scholar]
  17. Smith I., Clayton B. E., Wolff O. H. New variant of phenylketonuria with progressive neurological illness unresponsive to phenylalanine restriction. Lancet. 1975 May 17;1(7916):1108–1111. doi: 10.1016/s0140-6736(75)92498-8. [DOI] [PubMed] [Google Scholar]
  18. Smith I., Wolff O. H. Natural history of phenylketonuria and influence of early treatment. Lancet. 1974 Sep 7;2(7880):540–544. doi: 10.1016/s0140-6736(74)91873-x. [DOI] [PubMed] [Google Scholar]
  19. Woolf L. I. Mass screening of the newborn for metabolic disease. Arch Dis Child. 1968 Apr;43(228):137–140. doi: 10.1136/adc.43.228.137. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES