rjallen | Faculty Memoir Project

Richard J. Allen Professor Emeritus of Pediatrics and Neurology Medical School

Biography

Richard J. Allen received his B.S. in 1945 and M.D. in 1949, both from the University of Michigan. He then completed residency training in pediatrics and earned an M.S. in neuroanatomy in 1953, also at the University of Michigan. Following military service in Korea, he trained in pediatric neurology at Columbia University and then returned to his alma mater as an Instructor in Pediatrics in 1957. Dr. Allen has spent his entire career at the University of Michigan. He was named Professor and Director of Pediatric Neurology in 1968 and retired as Professor Emeritus in 2000.

Throughout his career, Dr. Allen has been dedicated to the study of inborn metabolic diseases, including the diagnosis and medical, nutritional and neurological treatment of children with these disorders. He published his first scientific paper on phenylketonuria (PKU) in 1960 and has been a national leader in the field ever since. When Michigan began universal neonatal screening for PKU in 1965 using Dr. Guthrie’s test, Dr. Allen collaborated with the Department of Public Health to initiate treatment for all infants identified with PKU. With NIH support for the next 22 years, he treated several hundred patients with PKU from birth to adulthood. As Director of the Pediatric Neurology Metabolic Diseases Laboratory and Clinic, he provided all the clinical treatment, laboratory study and monitoring for these children with PKU as well as children with a variety of other metabolic diseases. When Michigan began screening for galactosemia in 1987, Dr. Allen again collaborated with the Department of Public Health to initiate treatment for all infants identified with this disorder as well. In 1988 he helped found the International Society for Neonatal Screening as a Charter Member. His scientific findings and clinical results have been published in more than 80 scientific articles and chapters as well as more than 80 national and international presentations.

Dr. Allen was a founder of the Child Neurology Society (CNS) and hosted its first national meeting in Ann Arbor in 1972. He served as the Secretary/Treasurer of the CNS from 1972 to 1975 and then was the President of the CNS from 1976-1977. For many years he was the only child neurologist in Michigan and throughout his career he has treated thousands of children with all types of developmental disabilities. For many years, he was also the consulting neurologist for several developmental centers in Michigan. In 40 years as a member of the Medical School faculty at the University of Michigan, he taught several generations of students, residents and fellows about metabolic disease and child neurology. Many of his publications concern the diagnosis and treatment of general neurologic disorders of childhood including epilepsy, where he elucidated many of the metabolic and toxic manifestations of valproic acid therapy. In all of these clinical, academic, research and leadership activities, Dr. Allen has played a key role in the development of the field of child neurology both locally and nationally.

Dr. Allen has chaired or served on many state and national committees including the Developmental Disabilities Council and the Genetics Advisory Committee. He has received numerous awards in recognition of his lifelong commitment to improving the care of children with inborn metabolic disorders and developmental disabilities. The American Association on Mental Retardation presented the Robert Guthrie Award for Advances in Biomedical and Molecular Genetics to Dr. Allen on May 27, 1999, at their 123rd Annual Meeting in New Orleans, Louisiana.

Curriculum Vitae

Dr.Allen CV.pdf

Publications

Ann. Neurol.011.pdf

Memoirs

NAME: Richard J. Allen, MD, Professor Emeritus, Pediatrics & Neurology

Department affiliation: Department of Pediatrics (and Neurology)

Where did you attend college as an undergraduate? UM (BS, 1945)

Where and when did you attend medical school? UM (MD, 1949; MS, 1953)

During what years were you on the faculty at Michigan? 1956-2000

Who were some of the people you most influenced you at the UM? James Wilson, MD (Chairman, Pediatrics); H. Towsley, MD (Pediatrics); B. Grahm (Pediatrics); Dr. Tsao (PhD, Pediatric Laboratory); R. DeJong, MD (Chairman, Neurology); Dr. E. Crosby (Director, Neuroanatomy); Dr. Bagchi (Director, EEG Laboratory); Dr. Scheinberg (Director, Neuropathology).

Can you briefly discuss your teaching and research responsibilities? Teaching: Development, metabolic and pediatric clinical Neurology, in subspecialty clinics, in-patient service, and neurology core curriculum lectures (with Dr. B. Agranoff). Research: Grant support (1964 to present) Pediatric Neurology Metabolic Clinic and Laboratory for disorders detected by Newborn Screening (NBS) for the prevention of neurological disabilities in infants and children.

What were you most known for professionally? (1) First subspecialty clinic (1960) in pediatric neurology and for neurometabolic disorders (i.e., mental retardation, cerebral palsy, epilepsy, neurodegenerative and metabolic disorders). (2) First multidisciplinary metabolic clinic for treatment of infants born in Michigan following 1965 legislative mandate (PKU in 1956) extended to Galactosemia (GALT), Biotinidase deficiency (BD), Maple Syrup Urine disease (MSUD) in 1987.

Can you describe your first job? Dr. James Wilson, Chairman, invited me to return to the Department of Pediatrics (1956) after a three-year absence including Child Neurology Fellowship (NIH fellowship in Child Neurology, Neurological Institute, NY) to establish subspecialty services for infants and children with neurological disabilities.

What are some of your fondest memories of Michigan? Outstanding Michigan academic environment and leadership of Dr. James Wilson, as well as excellent faculty (in Pediatrics and Neurology) permitting expansion and recognition of the new specialty, Pediatric (Child) Neurology

What are some of your greatest contributions at Michigan? (1) The discovery (Dr. Robert Guthrie) and application of a simple laboratory “Newborn Screening” (NSB) test using a “drop of neonatal heel-prick blood” for laboratory diagnoses followed by dietary treatment employing newly discovered modifications for (“rare”) metabolic diseases prevented “mental retardation” and became a remarkable new concept, ultimately leading to universal national and international newborn screening. A Michigan legislative mandate in 1965 support by NIH and MDCH grants established the first state wide multidisciplinary program for all suspected neonates following NBS as the UM Pediatric Neurology Metabolic Clinic (PNMC). (2) The evolution of Pediatric Neurology as a recognized specialty began in Ann Arbor, Michigan at the first nationwide meeting (1972). As one of the seven founding members, this first organizational and scientific meeting established the Child Neurology Society (CNS) that held its 31^st national meeting in October 2003. I was honored by election first to Secretary-Treasurer and then President (1977) to the society that now represents over 1,000 pediatric neurologists worldwide.

Physicians trained under my direction at Michigan:

David L. Coulter, M.D., currently practicing at Boston Children's Hospital

John C. Heffelfinger, M.D., University of Michigan (deceased)

George M. Nidiffer, M.D., currently practicing in Marquette, MI

Roberto Rendon, M.D., currently practicing in Philadelphia, PA

Luis F. Salguero, M.D., currently practicing in Guatemala City

MEMOIRS: Richard J. Allen MD (1942-2000)

Dr. Richard Allen attended the University of Michigan from 1945 (BS) to 2000; Emeritus Professor (1968) in Medical School, MD (1949) and MS (1953). Air Force Honorable Discharge (Captain, 1953-55). Followed by one year at the New York Neurological Institute (NINDB Fellowship grant, 19556-56). Returned to UM (1957-58) as Instructor, Department of Pediatrics; Chair, Dr. James Wilson, supported development of Pediatric Neurology. Sabbatical leaves in 1969 (University College Hospital, London, Dr. C. Dent) and 1982 as Visiting Professor of Neurology in Research Laboratory, Dr. S. DiMauro, Neurological Institute, Presbyterian Medical Center, New York.

MEMOIR (1): METABOLIC SCREENING OF MICHIGAN INFANTS AT BIRTH (NBS) EMPLOYED BLOOD SPOTS AND BEGAN JULY, 1965.

An NIH grant (~1960) provided a metabolic laboratory employing a Amino Acid Analyzer and staff for assaying blood specimens of infants and children in pediatric neurology clinics for increased phenylalanine blood levels (Phenylalanine Levels, R.J. Allen, N ENG J MED, 270: 1367-1368, 1964). Michigan Department of Public Health (MDPH) became aware of the UM project and invited Dr. Allen to arrange collaboration of NBS testing for all Michigan infants initially for PKU (~160,000 births/year), a disorder of phenylalanine metabolism causing “mental retardation”. Initial “positive” MDPH screening tests were referred to the UM laboratory and clinic for confirmation and treatment. The fist studies of the effects of treatment were reported in Amino Acid Metabolism and Genetic Variation, edited by WL Nyhan, McGraw Hill, Inc. 1967, Variations in Hyper-phenylalinemia, p. 69-96, RJ Allen, L. Fleming, R. Spirito.

The clinical program (dietician, psychologist, nurse, doctor) established long-term care for all diagnoses NBS patients (see 1968 (1^st Edition) and 1992 (2^nd Edition) from the Pediatric Neurology Metabolic Clinic (PNMC) published “Monitoring Blood Levels at Home for Infants, Children and Adults with PKU and other Disorders”. This 21 page booklet provided instructions for collecting blood specimens at home for the follow up of affected infants and children, to be mailed to the UM Metabolic Laboratory.

The Michigan NBS program continued for 35 years and expanded to include MSUD (Relationship of causative genetic mutations in maple syrup urine disease with their clinic expression, Molecular Genetics and Metabolism. M. Nellis, A. Kasinski, M. Carlson, Richard Allen, A. Schaefer, EM Schwartz, Dean J. Danner, 80: 189-195, 2003) and Biotinidase (Deficient biotinidase activity in late onset multiple carboxylase deficiency. Wolf B, Grier RE, Parker WD, Goodman SI, and Allen, RJ, N. Engl. J. Med., 308:161, 1983) and (Galactosemia).

During these years, NBS was introduced in all US states to 30-50 disorders. In 1979, a four week old, ill infant was referred to the Pediatric Neurology Metabolic Clinic. The infant was weak throughout with macrocephaly; lab tests for hyperhomocysteinemia. The infant had a remethylation disorder (MTHFR), responded to treatment. Still under treatment at the age of 33 years (Progressive Neonatal Leukoencephalomyopathy Due to Absent Methylenetetrahydrofolate Reductase, Responsive to Treatment. RJ Allen, P Wong, S Rothenberg, S DiMauro, and JT Headington. Ann. Neuro., 1980, 8(2): 211).

MEMOIR (2): THE ORIGIN OF THE CHILD NEUROLOGY SOCIETY

The development of a national CHILD NEUROLOGY SOCIETY began on October 5-7, 1972, as participants from various states and countries attended the first organizational meeting to be held at The Towsley Center, UM Medical School, invited by Dr. Richard Allen. Dr. Kenneth Swaiman (Minneapolis) and Dr. Allen encouraged interested MD’s to meet and develop a Child Neurology Society. Many (see attachment) agreed to meet at the University of Michigan on October 5-7, 1972, when the FIRST NATIONAL MEETING OF THE CHILD NEUROLOGY SOCIETY was held. Officers and procedures were established at this first meeting.

MEMOIR (3): ROBERT J. GUTHRIE AWARD, 1999

American Association on Mental Retardation (AAMR), Health Promotion and Disability Prevention Committee for Biochemical and Molecular Genetics, May 27, 1999, New Orleans, LA: Richard J. Allen, MD, University of Michigan (see attached Annual Meeting program).