Abstract
WE have previously described a syndrome of severe and prolonged unconjugated hyperbilirubinæmia associated with breast feeding in seven full-term new-born infants in whom no other cause of jaundice was found1. The highest serum bilirubin concentrations in these infants were 14.3–24.5 mg per cent and were observed between the 10th and 19th days of life. Following abrupt cessation of breast feeding, hyperbilirubinæmia disappeared in 2–6 days. Milk from the mothers of these jaundiced infants consistently inhibited hepatic glucuronyl transferase activity in vitro, while milk from mothers whose children were normal did not. 150–400 c.c. of milk from three of the mothers was examined in an attempt to identify an inhibitor. In each of the three cases investigated a steroid was isolated and identified as pregnane-3(α), 20(β)-diol. This steroid competitively inhibits glucuronyl transferase activity in vitro. From the quantity of pregnane-3(α), 20(β)-diol isolated from milk, we estimated that the jaundiced infants ingested approximately 1.0 mg of steroid per day.
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Arias, I. M., Gartner, L. M., Seifter, S., and Furman, M., J. Clin. Invest. (in the press).
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Gartner, L., and Arias, I. M., Amer. J. Physiol., 205, 663 (1963).
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ARIAS, L., GARTNER, L. Production of Unconjugated Hyperbilirubinæmia in Full-term New-born Infants following Administration of Pregnane-3(alpha), 20(beta)-diol. Nature 203, 1292–1293 (1964). https://doi.org/10.1038/2031292b0
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DOI: https://doi.org/10.1038/2031292b0
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