glycodeoxycholic-acid and Diarrhea--Infantile

Measurements of serum bile acids (glycine conjugates of cholic, chenodeoxycholic, deoxycholic, and lithocholic acids) by radioimmunoassay in a variety of pediatric hepatobiliary disorders showed elevations in neonatal hepatitis syndromes, cholestasis, and hepatitis of extrahepatic or intrahepatic origin. Measurements of individual serum bile acids failed to differentiate between the various neonatal hepatitis syndromes. In one patient with cholestasis, the increased levels of bile acids observed returned to normal following therapy with cholestyramine and phenobarbital. In chronic active hepatitis the serum bile acid values correlated well with the bilirubin and SGOT in response to therapy with corticosteroids. These data confirm suggestions that serum cholylglycine and chenodeoxycholylglycine levels are a sensitive indicator of disturbed hepatic function and can be used in monitoring the course, activity, and therapeutic response in various hepatitis syndromes. In Reye's syndrome and protracted diarrhea of infancy, elevations in serum bile acids were detected without associated hyperbilirubinemia and provided additional evidence of disturbed hepatic function.

Topics: Adolescent; Bile Acids and Salts; Child; Child, Preschool; Cholestasis; Cystic Fibrosis; Diarrhea, Infantile; Glycochenodeoxycholic Acid; Glycocholic Acid; Glycodeoxycholic Acid; Hepatitis; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Diseases; Liver Diseases; Reye Syndrome

Significant elevations in two glycine-conjugated serum bile acid levels (cholic and chenodeoxycholic) were detected in a majority of infants with intractable diarrhea of infancy. In contrast, children with chronic inflammatory bowel disease had values of serum bile acids within the normal range. Although intravenous alimentation and constant-infusion elemental diet may alter hepatic function, serum bile acid levels were also elevated in other infants with intractable diarrhea not treated by these methods. We hypothesize that endotoxemia or other unknown mechanisms together with therapy are exerting a detrimental effect on hepatic function.

Topics: Bile Acids and Salts; Chenodeoxycholic Acid; Child; Child, Preschool; Diarrhea, Infantile; Glycocholic Acid; Glycodeoxycholic Acid; Humans; Infant; Lithocholic Acid