Serum phenylalanine concentrations decreased in 4 patients with hyperphenyl
alaninemia after loading with tetrahydrobiopterin. There were no abnormalit
ies in urinary pteridine excretion or in dihydropteridine reductase activit
y. However, mutations were detected in the phenylalanine hydroxylase gene,
suggesting a novel subtype of phenylalanine hydroxylase deficiency that may
respond to treatment with cofactor supplementation.