title: Ursodeoxycholic acid treatment in children with Byler disease.
abstract: 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.
authors.affiliation: Department of Pediatrics, Hacettepe University, School of Medicine, Ankara, Turkey. pedgastr@domi.com.tr
authors.forename: G
authors.initials: G
authors.lastname: Dinler
authors.forename: N
authors.initials: N
authors.lastname: Koçak
authors.forename: H
authors.initials: H
authors.lastname: Ozen
authors.forename: A
authors.initials: A
authors.lastname: Yüce
authors.forename: F
authors.initials: F
authors.lastname: Gürakan
mesh_terms: D002648:Child; D002675:Child, Preschool; D002756:Cholagogues and Choleretics / Q000627:therapeutic use*; D002780:Cholestasis, Intrahepatic / Q000188:drug therapy* / Q000235:genetics; D005260:Female; D006801:Humans; D007223:Infant; D008111:Liver Function Tests; D008297:Male; D018709:Statistics, Nonparametric; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
chemical_list: D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid