ABSTRACT

Background: Tetrahydroxy bile acids present at negligible or undetectable levels in healthy human adults but present at elevated levels in urine of infants with cholestasis clinically are the most valued marker of cholestasis next to serum tests. Methods: Twenty subjects with cholestasis, age range between seven days and one year, the study measured urinary tetrahydroxy bile acids for all cases. Results: Study found the presence of urinary tetrahydroxy bile acids in new-borns and infants with infantile cholestasis. New-borns and infants with a good prognosis had higher tetrahydroxy bile acids levels than those with a poor prognosis according to their outcomes. Conclusion: The study found the incidence of urinary tetrahydroxy bile acids in new-borns and infants with infantile intra-hepatic and extra-hepatic cholestasis. Extra-hepatic cholestatic patients had higher tetrahydroxy bile acids urine level than intra-hepatic, Cytomegalovirus and idiopathic neonatal hepatitis patients had a lesser tetrahydroxy bile acids level than in patients with genetic cholestasis. Tetrahydroxy bile acids play a role in clinical managing and treatment, in addition to their possible defensive properties against hepatic injury.

ABSTRACT
Background: Cholestasis, also known as prolonged jaundice, is characterized by 
a reduction in bile flow. Vitamin D3 is a fat-soluble vitamin whose absorption 
is affected by bile acids passing through the bile ducts. The primary objective 
was to determine the clinical utility of serum vitamin D3 in infants and 
children with cholestasis. Materials and Methods: Using an enzyme-linked 
immunosorbent assay, vitamin D3 levels in the blood serum of sixty patients 
with cholestasis, twenty patients with non-cholestatic causes, and twenty-five 
healthy subjects ranging in age from one day to fourteen years were 
determined. Results: Comparing intra- and extra-hepatic cholestasis groups to 
the control group, intra- and extra-hepatic cholestasis groups showed a highly 
significant decrease in serum vitamin D3 (P<0.001), while there was no 
significant difference between the control and non-cholestatic jaundiced 
groups (P= 0.069), and there was no significant difference between the old and 
newly diagnosed intra-hepatic cholestatic groups (p = 0.627). Conclusion: The 
amount of vitamin D3 in the serum of those with extra-hepatic cholestasis is 
lower than those with intra-hepatic cholestasis, indicating a poor prognosis for 
cholestasis illness

Abstract
One of the most important parameters to evaluate severity and type of cholestasis disease is gamma-glutamyl 
transferase and citrin protein measurements. The objective of this study was to assess the clinical value of 
serum citrin protein with gamma-glutamyl transferase in children with cholestasis.60 subjects with diseases 
and 25 healthy subjects distributed into three groups, citrin and gamma-glutamyl transferase were measured 
for all case and control studies by enzyme-linked immunosorbent Assay. The results showed serum citrin 
has a highly significantly decreased in an intra- and extrahepatic cholestasis groups when compared with 
control (P<0.001), serum gamma-glutamyl transferase has a highly significantly elevated in an intrahepatic 
cholestasis group when compared with control (P<0.003). From these findings it was concluded that serum 
gamma-glutamyl transferase level is a good marker in determining the severity of cholestasis disease, serum 
citrin may be useful in future to diagnose the cholestasis caused by citrin deficiency.

Abstract

Background: Early and successful individualized management of infantile cholestasis depends on the time of diagnosis. Objective: The objective of the study is to assess the clinical value of serum total bilirubin, direct bilirubin, and alkaline phosphatase in children with cholestasis. Materials and Methods: Sixty patients with diseases and 25 healthy controls distributed into three groups – total/direct bilirubin, and alkaline phosphatase were measured for all case and control studies by enzyme-linked immunosorbent assay. Results: The results showed serum total, direct bilirubin, and alkaline phosphatase have a highly significantly elevated in intra- and extra-hepatic cholestasis groups when compared with control (P < 0.001). There was a significantly elevated serum total and direct bilirubin when compared the extrahepatic cholestatic group with intrahepatic cholestatic group (P = 0.002 and 0.017), and there was no statistical difference between the intrahepatic cholestatic patients and extrahepatic cholestatic group when serum alkaline phosphatase measured (P = 0.610). Conclusion: From these findings, it was concluded that the level of direct bilirubin in sera of extrahepatic cholestasis group when compared with intrahepatic cholestasis group is elevated, serum total bilirubin, and alkaline phosphatase levels are good markers in determining the poor prognosis of cholestasis disease.