EFFECTS OF PHENOBARBITAL ON BILIARY LIPID-METABOLISM IN CHILDREN WITH CHRONIC INTRAHEPATIC CHOLESTASIS

The effects of phenobarbital (5.4-7.5 mg/kg body wt) for 14 days were studied in 4 children with severe intrahepatic cholestasis (group 1) and in 4 with a syndromatic type of paucity of intralobular bile ducts (group II). Phenobarbital administration resulted in a moderate improvement of pruritus in all patients. There was a significant decrease of bilirubin in serum (group I: from 4.8-2.7 mg/dl; group II: from 6.1-2.1 mg/dl); total bile acids (group I: from 416-337 .mu.mol/l; group II: from 156-123 .mu.mol/l) and cholesterol (group I: from 248-207 mg/dl; group II: from 351-292 mg/dl). Alkaline phosphatase activity increased from 929-1126 U/l in group I and from 1751-2360 U/l in group II. SGOT [serum glutamic oxaloacetic transaminase] and SGPT [serum glutamic pyruvic transaminase] activities remained unchanged in both groups. In group I total biliary lipid concentration and bile acid output increased from 0.09-0.17 g/dl and from 3.9-7.2 .mu.mol/kg per 30 min, respectively. Molar percentages of cholesterol, phospholipids and bile acids in bile remained unchanged. In group II total lipid concentrations and bile acid output increased from 1.62-2.0 g/dl and from 27.8-39.1 .mu.mol/kg per 30 min, respectively. The molar percentage of cholesterol decreased from 5.6-3.5 mol%. Short term administration of phenobarbital has only minimal effects on biliary lipid metabolism in children with chronic intrahepatic cholestasis.