Urinary bile acid profile in children with inborn errors of bile acid metabolism and chronic cholestasis; screening technique using electrospray tandem mass-spectrometry (ES/MS/MS).
BACKGROUND
It is well known that urine becomes the major route for bile acid excretion in liver diseases and thus we examined bile acid profile in urine obtained from normal children and children having chronic liver diseases using electrospray tandem mass spectrometry (ES/MS/MS).


METHODS
Bile acid were extracted from 5 ml of urine obtained from five healthy children or from twenty patients with various liver diseases including patients with unknown chronic liver diseases, Zellweger syndrome, peroxisomal bifunctional protein deficiency disease, tyrosinema type 1, biliary atresia, and patients with progressive familial intrahepatic cholestasis (PFIC) of undetermined type. Identification and quantification of bile acids were achieved in 5 minutes using electrospray tandem mass spectrometry (ES/MS/MS).


RESULTS
Urinary bile acid excretion increased in liver diseases an average of 100 times as compared to control values. There was a specific profile for different liver disease which confirms the pathology of the disease and could be used for its diagnosis. The results also show that the ions used for the diagnosis of oxo-steroid reductase deficiency disease were present in other chronic liver diseases suggesting that these atypical bile acids may not be a result of an inborn error of bile acid metabolism.


CONCLUSIONS
The urinary bile acid profile obtained in this study by ES/MS/MS can be of use for the diagnosis of certain chronic liver diseases.
Yousef
Ibrahim M
IM
Department of Pharmacology, Universite de Montreal, Montreal, Quebec, Canada. ibrahim.yousef@umontreal.ca
Perwaiz
Shahid
S
Lamireau
Terry
T
Tuchweber
Beatriz
B
D001647:Bile Acids and Salts / Q000652:urine*; D001656:Biliary Atresia / Q000652:urine; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002779:Cholestasis / Q000652:urine*; D002780:Cholestasis, Intrahepatic / Q000235:genetics / Q000652:urine; D002908:Chronic Disease; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000652:urine; D008661:Metabolism, Inborn Errors / Q000652:urine*; D018901:Peroxisomal Disorders / Q000652:urine; D012016:Reference Values; D021241:Spectrometry, Mass, Electrospray Ionization / Q000379:methods*; D013577:Syndrome; D020176:Tyrosinemias / Q000652:urine
D001647:Bile Acids and Salts