Guide for diagnosis and treatment of hyperphenylalaninemia

Haruo Shintaku, Toshihiro Ohura, Masaki Takayanagi, Shigeo Kure, Misao Owada, Yoichi Matsubara, Makoto Yoshino, Yoshiyuki Okano, Tetsuya Ito, Torayuki Okuyama, Kimitoshi Nakamura, Masafumi Matuo, Fumio Endo, Hiroyuki Ida

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Importance: Sapropterin hydrochloride, a natural coenzyme (6R-tetrahydrobiopterin) of phenylalanine hydroxylase, was first approved as a treatment for tetrahydrobiopterin deficiency in 1992 in Japan, and was then approved as a treatment for a tetrahydrobiopterin-responsive hyperphenylalaninemia in 2007 and 2008, in the USA and Japan, respectively. Guidelines are required on the proper use of sapropterin hydrochloride for tetrahydrobiopterin-responsive hyperphenylalaninemia. Observations: It is recommended that tetrahydrobiopterin-responsive hyperphenylalaninemia should be diagnosed in all cases of hyperphenylalaninemia, including phenylketonuria, by tetrahydrobiopterin administration tests rather than by phenotype or blood phenylalanine levels. Conclusions and Relevance: If tetrahydrobiopterin-responsive hyperphenylalaninemia is diagnosed, all ages can be treated with sapropterin hydrochloride. Although there are reports that sapropterin hydrochloride is effective and safe for the prevention of maternal phenylketonuria, further investigation is required.

Original languageEnglish
Pages (from-to)8-12
Number of pages5
JournalPediatrics International
Issue number1
Publication statusPublished - 2021 Jan


  • hyperphenylalaninemia
  • maternal phenylketonuria
  • phenylketonuria
  • tetrahydrobiopterin
  • tetrahydrobiopterin-responsive hyperphenylalaninemia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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