Abstract
Scattered reports of hepatic dysfunction during TPN led us to review the incidence of abnormal liver function tests (LFT) in patients receiving TPN. Sufficient data for analysis were available in 52 of 93 patients. None had liver disease or other explanations for the abnormal LFTs. The number of patients in each diagnostic category in whom abnormalities developed and the incidence of specific abnormalities are shown:
None of 18 patients who received TPN fewer than 21 days but 11 of 34 who received TPN longer than 21 days developed persistent SGOT/SGPT>100 IU and direct bilirubin>2 mg/dl. Definite worsening of biochemical abnormalities occurred in 14 of 21 patients monitored during reinstitution of enteral feeding. Histological changes of intracellular and canalicular cholestasis with steatosis were seen in the 5 biopsy and 9 post-mortem specimens examined.
In our experience, most patients receiving TPN develop hepatic dysfunction. Although the etiology is unknown, it is suggested that failure to maintain normal bile flow and/or alterations in bile production play a role.
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Collins, J., Pulito, A. & Heird, W. HEPATIC DYSFUNCTION DURING TOTAL PARENTERAL NUTRITION (TPN). Pediatr Res 11, 442 (1977). https://doi.org/10.1203/00006450-197704000-00433
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DOI: https://doi.org/10.1203/00006450-197704000-00433