Abstract
Extract: Changes in serum bile acid concentrations, before and after cholestyramine therapy, in a group of seven infants with extrahepatic biliary atresia and other cholestatic syndromes were measured with gas-liquid chromatography. Table I lists pertinent clinical and laboratory data and documents that all had consistently marked elevations of serum bile acid levels ranging from 48 to 444 $mUg/ml. Four infants with biliary atresia had predominantly chenodeoxycholate in plasma. Administration of cholestryamine caused a reduction in serum bile acids in some infants and a slight increase in the cholate to chenodeoxycholate ratio from less than 1 to a maximum of 1.3. Three children with intrahepatic cholestatic syndromes had predominantly cholic acid in plasma. Cholestyramine caused a reduction in total serum bile acids with an increase in the cholate to chenodeoxycholate ratio from 3.5 to 13. The rationale for the use of cholestyramine is based on its capacity to bind bile salts in the intestines.
Speculation: Analysis of serum bile acid pattern in infants with cholestatic syndromes before and after cholestyramine administration may identify infants with intrahepatic disease and thus avoid surgical exploration.
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Javitt, N., Morrissey, K., Siegel, E. et al. Cholestatic Syndromes in Infancy: Diagnostic Value of Serum Bile Acid Pattern and Cholestyramine Administration. Pediatr Res 7, 119–125 (1973). https://doi.org/10.1203/00006450-197303000-00003
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DOI: https://doi.org/10.1203/00006450-197303000-00003
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