title: Reversal of parenteral nutrition-associated liver disease in two infants with short bowel syndrome using parenteral fish oil: implications for future management.
abstract: Here we report the reversal of cholestasis in 2 infants with intestinal failure and parenteral nutrition-associated liver disease. Treatment involved the substitution of a conventional intravenous fat emulsion with one containing primarily omega-3 fatty acids. Biochemical tests of liver function improved significantly. One child was removed from the liver transplantation list because of improved hepatic function, and the second child had complete resolution of cholestasis while solely on parenteral nutrition. This suggests that fat emulsions made from fish oils may be an effective means of treating and preventing this often-fatal condition. A randomized, controlled trial is necessary to study the efficacy of this new approach to parenteral nutrition-associated liver disease.
authors.affiliation: Department of Pharmacy, Children's Hospital Boston, 300 Longwood Ave, Boston, Massachusetts 02115, USA.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Gura
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Duggan
authors.forename: Sharon B
authors.initials: SB
authors.lastname: Collier
authors.forename: Russell W
authors.initials: RW
authors.lastname: Jennings
authors.forename: Judah
authors.initials: J
authors.lastname: Folkman
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Bistrian
authors.forename: Mark
authors.initials: M
authors.lastname: Puder
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002779:Cholestasis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D005217:Fat Emulsions, Intravenous / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D005395:Fish Oils / Q000008:administration & dosage* / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D045822:Intestinal Volvulus / Q000601:surgery; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects*; D012778:Short Bowel Syndrome / Q000097:blood / Q000628:therapy*
chemical_list: D005217:Fat Emulsions, Intravenous; D005395:Fish Oils; D002097:C-Reactive Protein; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin