Hyperalimentation-associated jaundice: an example of a serum factor inducing cholestasis in rats

• Published in: The American journal of clinical nutrition Vol. 41; no. 1; pp. 61 - 65
• Main Authors: Latham, PS, Menkes, E, Phillips, MJ, Jeejeebhoy, KN
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Elsevier Inc 01.01.1985; American Society for Clinical Nutrition
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; bile flow; Biological and medical sciences; cholestasis; Cholestasis - blood; Cholestasis - etiology; Emergency and intensive care: injuries, diseases due to physical agents. Diving. Drowning. Disaster medicine; Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition; endotoxin; Endotoxins - toxicity; Humans; hyperalimentation; Intensive care medicine; Intestine, Small - surgery; Jaundice; Male; Medical sciences; Parenteral Nutrition - adverse effects; Parenteral Nutrition, Total - adverse effects; Rats; Rats, Inbred Strains; Jaundice; hyperalimentation; cholestasis; bile flow; endotoxin; Rat; Rodentia; Experimental study; Hepatobiliary disease; Parenteral administration; Feeding; Vertebrata; Mammalia; Cholostasis; Digestive diseases; Complication; Resuscitation
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/41.1.61

A patient receiving total parenteral nutrition (TPN) at home following emergency resection of the small intestine was studied over a two year interval. Cholestatic jaundice developed after 6 months. A factor in serum was found to produce cholestatic changes in the bile flow of rats on intravenous infusion. Normal human serum and saline infusion did not produce this cholestasis. Endotoxin infusion in the rat produced a similar impairment in bile flow. The hypothesis was proposed that endotoxin might be an occult factor contributing to cholestasis in this case. An antiserum prepared to an endotoxin isolated from a sequestered E. coli infection in this patient, ameliorated the cholestatic effects of the patients' serum in rats. The possible role of endotoxin in the cholestasis of the TPN-induced jaundice in this patient is presented and discussed.