Abstract
To determine whether lithocholic acid (LCA) contributes to the occurrence of intrahepatic cholestasis associated with total parenteral nutrition (TPN-IHC) in neonates. we investigated the serum bile acid fraction of neonates on TPN. Twenty-five surgical neonates who received TPN for more than 2 weeks without enteral nutrition were studied. TPN-IHC was defined by having a serum direct bilirubin level of over 2.0mg/dl. Serum bile acid fraction was analyzed by HPLC using 3α-hydroxy steroid dehydrogenase. Eleven patients developed TPN-IHC during the first month of life, and 8 (32%; IHC group) had TPN-IHC when bile acid was analyzed. Serum total bile acid levels for both groups were 14.4 and 76.1nmol/ml, respectively. Glycine and taurine conjugated cholic and chenodeoxy cholic acid were detected in both the non-IHC and IHC groups, but only traces of unconjugated and secondary bile acids (deoxycholic and lithocholic acid) were found. In conclusion, LCA is unlikely to be a causative factor of TPN-IHC in neonates.
