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Intrahepatic cholestasis
The incidence of liver disease induced by TPN is higher in children than in adults and cholestasis is the most frequent TPN-related hepatic dysfunction occurring in children.TPN-IC is a liver complication that is evidenced by a rise in serum-conjugated bilirubin of 2 mg/dL or more, which may be accompanied by increases in ?-glutamyl transpeptidase, alkaline phosphatase, and serum transaminase.The indication for TPN in paediatric patients is frequently a primary gastrointestinal disorder causing IF (congenital intestinal abnormalities, necrotising enterocolitis).
Intrahepatic cholestasis
The incidence of liver disease induced by TPN is higher in children than in adults and cholestasis is the most frequent TPN-related hepatic dysfunction occurring in children. The indication for TPN in paediatric patients is frequently a primary gastrointestinal disorder causing IF (congenital intestinal abnormalities, necrotising enterocolitis). The need for a prolonged TPN regimen in these small patients may trigger cholestasis, fibrosis and cirrhosis and even cause liver failure. Hepatobiliary complications of TPN therefore remain a serious threat in younger patients who need long-term TPN to survive.
TPN-IC is a liver complication that is evidenced by a rise in serum-conjugated bilirubin of 2 mg/dL or more, which may be accompanied by increases in γ-glutamyl transpeptidase, alkaline phosphatase, and serum transaminase. This complication should be suspected in all the patients treated with hospital and home parenteral nutrition. Extrahepatic causes of cholestasis should be excluded, and the use of any drug with a possible hepatotoxic action should be suspended. In most patients, elevated.
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