[Total parenteral nutrition-related cholestatic hepatopathy, is it an infectious disease?].
The aim of this retrospective study was to determine whether total parenteral nutrition-related liver disease was improved by intravenous antibiotics given for systemic sepsis. Liver function tests were performed 1 month before, during and 1 month after one episode of sepsis treated for 4 weeks (mean, range: 2-12), with systemic antibiotics, in 12 patients receiving parenteral nutrition for 13 months (mean, range: 1-71) for short bowel syndrome in 10 of them. Cholestatic liver disease appeared in all during nutrition (mean serum alkaline phosphatase activity > 4 N). Liver test abnormalities observed at the beginning of antibiotics treatment were not significantly different from those observed 1 month before sepsis. Antibiotic administration was followed by a significant decrease (P < or = 0.03) in serum activities of alkaline phosphatases, ALT and AST and bilirubinemia of 38, 41, 23 and 47%, respectively. These results support the concept that parenteral nutrition-associated cholestatic liver disease may be related to intestinal bacterial overgrowth and suggest that it may be improved by intravenous antibiotherapy.
Beau
P
P
Service d'Hépato-Gastroentérologie, CHU La Milétrie, Poitiers.
Barrioz
T
T
Ingrand
P
P
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D000900:Anti-Bacterial Agents; D001219:Aspartate Aminotransferases / Q000097:blood; D001424:Bacterial Infections / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D001663:Bilirubin / Q000097:blood; D002779:Cholestasis / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology
D000900:Anti-Bacterial Agents; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001663:Bilirubin
L'hépatopathie cholestatique de la nutrition parentérale totale est-elle une maladie infectieuse?