Importance of choline during growth, with particular reference to synthetic diets in phenylketonuria.

Moncrieff and Wilkinson (1961) and Brimblecombe, Blainey, Stoneman and&-Wood (1961) have described the development of a severe extensive skin eruption in babies fed on the low-phenvlalanine food 'minafen' (Trufood Ltd.). More recently, two further phenylketonuric children have been seen at Great Ormond Street with bizarre rashes. One, a baby, developed a rash similar to that described by Moncrieff and Wilkinson (1961) while receiving minafen. From contacts with other paediatricians it has become apparent that a number of patients have developed this syndrome, and in some instances there has been a fatal outcome. The other, a 3-year-old child, developed the rash while receiving a grossly inadequate diet. In an attempt to elucidate possible causes of rashes in these children, synthetic low-phenylalanine foods have been fed to rats, and the effect of increasing certain nutritional factors has been studied. It was also possible to make some investigations on the older patient and these indicated the importance of choline, riboflavine and vitamin E. As a result of the investigations, certain modifications in the synthetic food have been suggested.