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K Motzfeldt

Publications and source records attributed to K Motzfeldt.

9 recordsLinked to original sources

Breastfeeding in phenylketonuria.

Eighty-three infants with classical phenylketonuria have been born in Norway since 1979. The treatment of these children is centralized at the National Hospital in Oslo. Seventy-four have been breastfed in combination with a phenylalanine-free protein substitute. Dietary treatment was commenced in hospital between 5 and 33 d of age (mean 14 d). Normalization of serum phenylalanine (below 400 pmol/l) took between 1 and 35 d (mean 8 d). The period of breastfeeding lasted from 1 to 16 mo (mean 7 mo). Growth (weight, length and head circumference) fell within the normal range for age on the Norwegian growth chart.

Breast Feeding↗

Phenylketonuria genotypes correlated to metabolic phenotype groups in Norway.

UNLABELLED: In order to establish a genotype-phenotype relationship, we have identified both mutant phenylalanine hydroxylase (PAH) genes in 108 phenylketonuria (PKU) patients (27 different alleles, 54 different genotypes). One major group of patients with very high pretreatment phenylalanine values ("classical" PKU) exclusively comprised homozygotes of the PKU mutations I65T, G272X, F299C, Y356X, R408W, IVS12nt1, and compound heterozygotes of various combinations of these alleles with G46S, R261Q, R252W, A259T, R158Q, D143G, R243X, E280K, or Y204C. A second major group of patients with lower phenylalanine values ("mild" PKU) comprised mutations A300S, R408Q, Y414C in various compound heterozygous states, and R261Q, R408Q, Y414C in homozygotes. The phenylalanine values in these groups were non-overlapping. In addition, a smaller group of patients formed the transition between the two main groups. In sib pairs 4 of 15 had discordant pretreatment phenylalanine values. CONCLUSION: Our results are consistent with the view that allelic heterogeneity at the PAH locus dominates the biochemical phenotype in PKU and that genotype information is able to predict the metabolic phenotype in PKU patients.

Child↗

Relative frequency, heterogeneity and geographic clustering of PKU mutations in Norway.

We have analysed 236 Norwegian phenylketonuria (PKU) alleles by a combination of mutation scanning methods, restriction enzyme-based assays and DNA sequencing. Thirty-three different mutations constituted 99.6% of all mutant alleles (only 1 allele remains unidentified), 23 of these have been identified also in other European countries. Twenty were predicted missense mutations, 6 splice mutations, 4 nonsense mutations and 2 deletion mutations and 1 mutation disrupted the start codon. The 8 most common mutations represented 83.5% of the PKU alleles, with single allele frequencies ranging from 5.9 to 15.7%. Four of these mutations (R261Q, R408W, Y414C, and 1VS12nt1) are commonly occurring also in PKU patients in other European countries, while the other 4 (G46S, G272X, F299C, and R408Q) have higher frequencies in Norway than in any other country studied. Six mutations (I65T, L249F, P281L, Y356X, R158Q, and R252W) have frequencies between 0.8% and 2.1%, and 19 mutations were encountered only once. The majority of PKU mutations were found on the same RFLP/VNTR haplotype backgrounds in Norway as in other European populations, suggesting that only a few of the mutations may represent recurrent mutations (< 3.4%). Among 10 mutations only reported for our population, we detected 2 de novo mutations (0.8%) arisen in Norway. From the birthplaces of the probands' grandparents, each mutation seemed to have an individual geographic distribution within Norway, with patterns of local mutation clustering. Our observations are compatible with multiple founder effects and genetic drift for the distribution of PKU mutations within Norway.

Alleles↗

[Screening of newborn infants in Norway for severe metabolic disease].

The objective of neonatal screening for phenylketonuria and congenital hypothyroidism is early diagnosis and initiation of treatment to prevent brain damage and mental retardation. We present the results of the Norwegian national neonatal screening programme for phenylketonuria and congenital hypothyroidism. Screening for phenylketonuria based on serum phenylalanine determinations started in 1967 and covered the whole country in 1978. National screening for congenital hypothyroidism started in 1979. One hundred children with phenylketonuria and 280 children with a strong indication of congenital hypothyroidism have been detected up to 1 October 1994. Screening-related challenges and principles of treatment are discussed.

Congenital Hypothyroidism↗

[Glutaric aciduria type I].

Glutaric aciduria type I is a congenital metabolic disease caused by an enzymatic defect in the degradation of the amino acids lysine and tryptophane. This article presents five Norwegian patients with this condition. Early clinical features may be similar to those of encephalitis. The further clinical course is dominated by choreoathetosis, hyperkinesis and spasticity. The diagnosis is made by tracing enhanced glutaric acid in the urine. The treatment is a low protein diet containing only small quantities of lysine and tryptophane. Four of our patients underwent a neuropsychological examination. Despite the fact that such patients are difficult to test, our examination indicates that the condition has a greater effect on motor than on cognitive functions.

Adolescent↗

[Children with phenylketonuria (Fölling's disease). Intellectual functions and psychological adaptation].

Untreated phenylketonuria (PKU) leads to serious mental retardation. The prognosis of PKU has been dramatically improved by neonatal screening and dietary treatment. This study evaluates 25 children, ages 10 to 16 years. Children who receive early and adequate treatment have a mean IQ slightly below normal, and few psychological problems. The disease causes considerable strain on the families, however, because of the very strict diet. Recent evidence suggests that children with PKU can only rarely terminate the diet, although in many cases the diet can be relaxed. It is essential to teach the children the diet and promote autonomy in relation to phenylketonuria.

Adaptation, Psychological↗

[Diet among patients with celiac disease. Do patients comply with a gluten-free diet?].

We studied dietary compliance retrospectively among 28 coeliac patients, 18 adults (15-68 years) and 10 children (1-14 years) by means of a self-administered frequency questionnaire. 50% of the participants ate foods that were not guaranteed to be gluten-free. Four adult patients (22%) with certainty did not keep to a strictly gluten-free diet. Lack of dietary compliance was not detected among children. The patients had received information on diet shortly after the disease had been diagnosed during the period 1964-81. The most frequent source of information about gluten-free diet was the physician, but information from the Norwegian Coeliac Association and from clinical nutritionists was rated as more useful. 24 patients reported experiencing social and practical problems related to the gluten-free diet.

Adolescent↗

Is phenylalanine requirement in infants and children related to protein intake?

Two groups of children with phenylketonuria (PKU) received protein at two different levels. The protein source was a protein hydrolysate, devoid of phenylalanine, and intact protein from milk, vegetables and fruit. One group (RDA group) was given protein at a level based on the recommendations of the (US) Food and Nutrition Board (1974, 1980). The other group (FAO group) was given protein at the level of intake corresponding to the Joint FAO/WHO ad hoc Expert Committee (1973) safe levels of intake of egg or milk protein. The children were monitored very closely for several years. From an earlier study evaluating the protein intake of the two groups it was suspected that the Joint FAO/WHO ad hoc Expert Committee (1973) recommendations were marginal. In the present study the phenylalanine intake of the two groups required to maintain the plasma phenylalanine concentration at the required level was established. The results showed that the RDA group required more phenylalanine than the FAO group. This difference was statistically significant from the age of 5-15 months. We have interpreted the greater requirement for phenylalanine in the RDA group as a result of a greater nitrogen intake and thus a more rapid chemical maturation of N (increase in protein concentration of the body with age). It is known that up to the age of 6 months the chemical maturation of N is related to the N intake. In the present study we have found that this difference in chemical maturation lasted up to the age of 15 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Weight↗

Protein requirements in infants and children: a longitudinal study of children treated for phenylketonuria.

Two groups of children with phenylketonuria were followed from birth for several years. The Recommended Dietary Allowance group received a protein intake as recommended by the Food and Nutrition Board. The Food and Agricultural Organization (FAO) group received a protein intake as recommended by FAO. The children were followed very closely for the biochemical control of the disease. The children were also followed very closely to evaluate the adequacy of the protein intake using length, weight, routine hematology, chemical analysis, and x-ray of the hand. The results indicated two groups of healthy children. However, a decline in length growth percentile was found in some of the FAO children. A possible osteoporosis developed in two of the FAO children. The possible conclusion that the FAO "safe level of intakes of egg or milk protein" is marginal is discussed.

Age Factors↗