Bile Acid Excretion and Malabsorption in Intrahepatic Cholestasis of Infancy (“Neonatal Hepatitis”)

Summary Bile acid excretion has been studied in four patients with intrahepatic cholestasis of infancy neonatal hepatitis) after intramuscular administration of cholic acid‐24‐ 14 .C Bile acid secretion to the intestines was found to be highly impaired and the main route of excretion was via the urine. Practically all of the administered labeled cholic acid was conjugated prior to excretion. The main conjugates were glycocholic and taurocholic acid. At least three additional conjugates of cholic acid were isolated from the urine. Analysis of bile obtained from three of the patients in connection with operative cholangiography showed a very low concentration of bile acids, phospholipids and cholesterol. The bile was of normal colour owing to the presence of bilirubin. Severe steatorrhea and markedly impaired absorption of vitamin A was demonstrated when the patients were jaundiced. The impairment of bile acid excretion to the gut and the degree of steatorrhea were well correlated. In some of the patients steatorrhea persisted after the disappearance of jaundice. In those instances, the impairment of bile acid excretion to the gut was found to persist.