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Without early treatment, PKU leads to severe intellectual impairment along with physical features like fair skin, spastic gait, and microcephaly (58)

Quality of evidence: II-B, Strength of recommendation: 1 Panel level of agreement: In total agreement 87%, in partial agreement 13% CFF measurement has been shown to be useful in diagnosing MHE

The neurobiological basis for this developmental change in GABA+ levels is unknown, but may result from the progression of ADHD with brain maturation

Goldminz AM, Au SC, Kim N, Gottlieb AB, Lizzul PF

Detection of protein carbonylation Levels of carbonylated proteins were determined with the OxyBlot protein oxidation detection kit following the manufacturers protocol (Millipore, Billerica, MA, USA)

Metabolic encephalopathy can be coded as a secondary diagnosis when it is clinically evaluated, monitored, or treated and supported by physician documentation with an identified underlying cause