Ursodeoxycholic acid treatment in children with Byler disease

Background: There have been a few reports of patients with Byler disease and the best medical treatment is not known. The aim of the present study is to show the effect of ursodeoxycholic acid (UDCA) on clinical, laboratory and histologic findings in children with Byler disease. Methods: Nine childr...

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Published in:Pediatrics international 1999-12, Vol.41 (6), p.662-665
Main Authors: Dinler, GÖNÜL, Koçak, NURTEN, Özen, HASAN, Yüce, AYSEL, Gürakan, FIGEN
Format: Article
Language:English
Subjects:
Byler disease
Child
Child, Preschool
children
Cholagogues and Choleretics - therapeutic use
Cholestasis, Intrahepatic - drug therapy
Cholestasis, Intrahepatic - genetics
Female
Humans
Infant
Liver Function Tests
Male
progressive familial intrahepatic cholestasis
Statistics, Nonparametric
ursodeoxycholic acid
Ursodeoxycholic Acid - therapeutic use
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Summary:Background: There have been a few reports of patients with Byler disease and the best medical treatment is not known. The aim of the present study is to show the effect of ursodeoxycholic acid (UDCA) on clinical, laboratory and histologic findings in children with Byler disease. Methods: Nine children aged between 1.5 and 9 years with Byler disease were administered UDCA orally at doses of 15–20 mg/kg per day. They were followed for at least 12 months. Clinical, laboratory and histologic outcomes were evaluated after 12 months of treatment. Results: Seven children presented in the first 6 months of life with itching and/or jaundice. Gamma‐glutamyl transpeptidase and cholesterol levels were normal in all patients, despite severe cholestasis. With UDCA therapy, pruritus disappeared/diminished in four (44.4%) patients. The mean serum concentrations of alanine aminotransferase, aspartate aminotransferase (AST), total and conjugated bilirubin decreased, although it was significant only for AST (P=0.01). Before treatment, all biopsy materials showed cellular/canalicular cholestasis and fibrosis. After UDCA therapy cholestasis was ameliorated. Two patients died during follow up. Conclusions: The results suggest that administration of UDCA leads to clinical and biochemical improvement in children with Byler disease. The UDCA ameliorates symptoms partially, improves the life quality of patients and may be given for as long as the disease continues.
ISSN:1328-8067
1442-200X
DOI:10.1046/j.1442-200x.1999.01143.x