TY - JOUR
T1 - Δ4-3-Oxosteroid 5β-reductase deficiency causing neonatal liver failure and hemochromatosis
AU - Shneider, Benjamin L.
AU - Setchell, Kenneth D R
AU - Whitington, Peter F.
AU - Neilson, Kathryn A.
AU - Suchy, Frederick J.
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 1994/2
Y1 - 1994/2
N2 - Neonatal liver failure was evaluated in two infants. Neither infant had evidence of congenital infection, galactosemia, α1-antitrypsin deficiency, tyrosinemia, Zellweger syndrome, or hemophagocytic lymphohistiocytosis. Abnormal levels of iron were detected in the minor salivary glands of the first infant and in the explanted liver of the second. Analyses of urinary bile salts by fast-atom bombardment ionization mass spectrometry and gas chromatography-mass spectrometry revealed a paucity of primary bile acids and a predominance of 7α- hydroxy-3-oxo-4-cholenoic and 7α, 12α-dihydroxy-3-oxo-4-cholenoic acids. These findings are consistent with Δ 4-3-oxosteroid 5β-reductase deficiency, a primary genetic defect in bile acid synthesis. Postmortem evaluation of the first infant revealed significant iron deposition in the liver, pancreas, thyroid, adrenal glands, myocardium, stomach, and submucosal glands of the respiratory tract. In both infants examination of the liver revealed extensive loss of hepatic parenchyma. These cases expand the clinical spectrum of bile acid metabolism defects to include neonatal liver failure with associated hemochromatosis. (J PEDIATR 1994;124:234-8).
AB - Neonatal liver failure was evaluated in two infants. Neither infant had evidence of congenital infection, galactosemia, α1-antitrypsin deficiency, tyrosinemia, Zellweger syndrome, or hemophagocytic lymphohistiocytosis. Abnormal levels of iron were detected in the minor salivary glands of the first infant and in the explanted liver of the second. Analyses of urinary bile salts by fast-atom bombardment ionization mass spectrometry and gas chromatography-mass spectrometry revealed a paucity of primary bile acids and a predominance of 7α- hydroxy-3-oxo-4-cholenoic and 7α, 12α-dihydroxy-3-oxo-4-cholenoic acids. These findings are consistent with Δ 4-3-oxosteroid 5β-reductase deficiency, a primary genetic defect in bile acid synthesis. Postmortem evaluation of the first infant revealed significant iron deposition in the liver, pancreas, thyroid, adrenal glands, myocardium, stomach, and submucosal glands of the respiratory tract. In both infants examination of the liver revealed extensive loss of hepatic parenchyma. These cases expand the clinical spectrum of bile acid metabolism defects to include neonatal liver failure with associated hemochromatosis. (J PEDIATR 1994;124:234-8).
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U2 - 10.1016/S0022-3476(94)70310-8
DO - 10.1016/S0022-3476(94)70310-8
M3 - Article
C2 - 8301429
AN - SCOPUS:0028177674
VL - 124
SP - 234
EP - 238
JO - Journal of Pediatrics
JF - Journal of Pediatrics
SN - 0022-3476
IS - 2
ER -