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Inborn Errors of Metabolism01:20

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Phenylketonuria (PKU) is a protein metabolism disorder characterized by high blood levels of the amino acid phenylalanine. This results from a mutation in the gene responsible for phenylalanine hydroxylase, an enzyme that converts phenylalanine into tyrosine. When this enzyme is deficient, phenylalanine builds up in the blood, leading to symptoms such as vomiting, rashes, seizures, growth deficiency, and severe mental retardation. An early diagnosis and a diet restricting phenylalanine intake...
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In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
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Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
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Updated: Mar 20, 2026

Biochemical Measurement of Neonatal Hypoxia
13:13

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Primary hyperoxaluria in infants.

Manel Jellouli1, Mariem Ferjani1, Kamel Abidi1

  • 1Department of Pediatric Nephrology, Charles Nicolle Hospital, Tunis, Tunisia.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|May 25, 2016
PubMed
Summary

Infantile primary hyperoxaluria type-1 (PH-1) leads to rapid kidney failure in infants. Early death is common, and combined liver-kidney transplantation is essential for survival.

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Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Medical Genetics

Background:

  • Infantile primary hyperoxaluria type-1 (PH-1) is a rare genetic disorder.
  • It causes rapid progression to end-stage renal disease (ESRD) in infants.
  • Limited data exists on the infantile form of PH-1.

Purpose of the Study:

  • To retrospectively analyze the clinical, biological, and radiological features of infants diagnosed with PH-1 within their first year of life.
  • To understand the disease's progression and outcomes in this specific pediatric population.

Main Methods:

  • Retrospective review of medical records of infants diagnosed with PH-1 between January 1995 and December 2013.
  • Inclusion criteria: infants diagnosed within the first 12 months of life.
  • Data collected included clinical presentation, biological markers, radiological findings, diagnostic methods, and treatment outcomes.

Main Results:

  • Fourteen infants (median age: 2 months) were included.
  • At diagnosis, 11 patients presented with ESRD, and all had nephrocalcinosis.
  • Diagnosis was confirmed via family history, crystalluria, molecular analysis, or kidney biopsy.
  • Seven of 11 patients with ESRD died; four are on peritoneal dialysis.
  • Only two patients maintained renal function, showing pyridoxine sensitivity.

Conclusions:

  • Infantile PH-1 with ESRD carries a high risk of early mortality.
  • Peritoneal dialysis is not the preferred treatment.
  • Combined liver-kidney transplantation is indicated as the mandatory treatment for affected children.