Effect of phenobarbital on serum and biliary parameters in a patient with Crigler-Najjar syndrome, type II and acquired cholestasis

Bruce W. Trotman, Leslie Shaw, Jayanta Roy-Chowdhury, Peter F. Malet, Ernest F. Rosato

Research output: Contribution to journalArticle

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Abstract

The effect of phenobarbital treatment on bilirubin metabolism and bile secretion was studied in a patient with Crigler-Najjar syndrome, type II and acquired cholestasis. Following cholecystectomy and choledochostomy, a balloon inflatable T tube was inserted to facilitate bile collection. Hepatic UDP-glucuronyltransferase in surgically obtained liver tissue was 25% of normal activity and bilirubin monoconjugates accounted for >80% of the pigments in bile. Phenobarbital therapy decreased the concentration of fasting serum bile acids by 33% and partially reestablished their enterohepatic cycling postprandially. The total fasting serum bilirubin concentration (>90% unconjugated) increased 21% during phenobarbital treatment and was unaffected by caloric intake. Bile flow was increased 2.7 times after phenobarbital treatment. The biliary concentration of total bilirubin was increased 2.4 times, primarily due to monoconjugated bilirubin, which accounted for 91% of the biliary pigments. Bile acid, phospholipid, cholesterol, and calcium concentrations in bile were significantly increased after phenobarbital. The data indicate that even in the presence of cholestasis an underlying deficiency in bilirubin conjugation may be confirmed by biliary pigment analysis.

Original languageEnglish (US)
Pages (from-to)753-762
Number of pages10
JournalDigestive Diseases and Sciences
Volume28
Issue number8
DOIs
StatePublished - Aug 1983

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Cholestasis
Phenobarbital
Bilirubin
Bile
Serum
Bile Acids and Salts
Fasting
Bile Pigments
Choledochostomy
Glucuronosyltransferase
Uridine Diphosphate
Liver
Cholecystectomy
Therapeutics
Energy Intake
Type 2 Crigler Najjar syndrome
Phospholipids
Cholesterol
Calcium

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Effect of phenobarbital on serum and biliary parameters in a patient with Crigler-Najjar syndrome, type II and acquired cholestasis. / Trotman, Bruce W.; Shaw, Leslie; Roy-Chowdhury, Jayanta; Malet, Peter F.; Rosato, Ernest F.

In: Digestive Diseases and Sciences, Vol. 28, No. 8, 08.1983, p. 753-762.

Research output: Contribution to journalArticle

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