Caso contributivo
Una colestasi senza prurito
Cholestasis without itching
Lorenza Matarazzo1, Stefano Martelossi1, Giuseppe Maggiore2, Gian Paolo Chiaffoni3 , Alessandro Ventura1
1IRCCS Materno-Infantile “Burlo Garofolo”, Università di Trieste
2Dipartimento di Pediatria, Ospedale Universitario Santa Chiara, Pisa
3UO Pediatria, Ospedale Civile, Conegliano (TV)
Maggio 2013
Abstract
Bile acids deficiency is characterized by an inadequate synthesis of bile salts with accumulation of abnormal hepatotoxic metabolites and liver damage. High levels of abnormal bile acid are found in urine. Clinical features include jaundice without itching, hepatomegaly, poor growth and steatorrhea. The onset is often with rickets. Cholic acid replacement at a dose of 10-15 mg/kg/daily is the therapy of choice.
Contenuto riservato
Per leggere l'articolo è necessario effettuare il login.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1) Bove KE Liver disease caused by disorders of bile acid synthesis. Clin Liver Dis 2000;4(4):831-48.
2) Sundaram SS, Bove KE, Lovell MA, Sokol RJ. Mechanisms of disease: Inborn errors of bile acid synthesis. Nat Clin Pract Gastroenterol Hepatol 2008;5(8):456-68. Epub 2008 Jun 24.
3) Monte MJ, Marin JJ, Antelo A, Vazquez-Tato J. Bile acids: chemistry, physiology, and pathophysiology World J Gastroenterol. 2009;15(7):804-16.
4) Maillette de Buy Wenniger L, Beuers U. Bile salts and cholestasis.Dig Liver Dis 2010;42(6):409-18.
5) Clayton PT. Disorders of bile acid synthesis.J Inherit Metab Dis 2011;34(3):593-604. Epub 2011 Jan 13.
6) Heubi JE, Setchell KD, Bove KE. Inborn errors of bile acid metabolism. Semin Liver Dis 2007;27(3):282-94.
7) Gonzales E, Gerhardt MF, Fabre M, et al. Oral cholic acid for hereditary defects of primary bile acid synthesis: a safe and effective long-term therapy. Gastroenterology 2009;137(4):1310-20.e1-3. Epub 2009 Jul 19.
8) Clayton PT.J Applications of mass spectrometry in the study of inborn errors of metabolism. Inherit Metab Dis 2001;24(2):139-50.
9) Akobeng AK, Clayton PT, Miller V, Super M, Thomas AG. An inborn error of bile acid synthesis (3beta-hydroxy-delta5-C27-steroid dehydrogenase deficiency) presenting as malabsorption leading to rickets. Arch Dis Child 1999;80(5):463-5.
10) Subramaniam P, Clayton PT, Portmann BC, Mieli-Vergani G, Hadzić N. Variable clinical spectrum of the most common inborn error of bile acid metabolism--3beta-hydroxy-Delta 5-C27-steroid dehydrogenase deficiency. J Pediatr Gastroenterol Nutr 2010;50(1):61-6.
11) Setchell KD, Suchy FJ, Welsh MB, Zimmer-Nechemias L, Heubi J, Balistreri WF.J Delta 4-3-oxosteroid 5 beta-reductase deficiency described in identical twins with neonatal hepatitis. A new inborn error in bile acid synthesis. Clin Invest 1988;82(6):2148-57.
12) Haas D, Gan-Schreier H, Langhans CD, et al. Differential diagnosis in patients with suspected bile acid synthesis defects. World J Gastroenterol 2012;18(10):1067-76.
13) Clayton PT, Mills KA, Johnson AW, Barabino A, Marazzi MG. Delta 4-3-oxosteroid 5 beta-reductase deficiency: failure of ursodeoxycholic acid treatment and response to chenodeoxycholic acid plus cholic acid. Gut 1996;38(4):623-8.
