PubMed · 13902278
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F GROSSI. 1962-05-15. [Choleretics].. https://pubmed.ncbi.nlm.nih.gov/13902278/
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BACKGROUND: We sought to determine the cause of reduced scotopic and photopic electroretinograms (ERGs) and night blindness in a 46-year-old man with liver dysfunction but no history of alcoholism. CASE: A 46-year-old Japanese man with a complaint of visual difficulties in dim light for 1 month. OBSERVATIONS: By electrophysiological investigation, the patient was found to have low levels of serum zinc and vitamin A on admission. The rod b wave was unrecordable, and the bright-flash ERGs were reduced, with the a wave > b wave. The amplitudes of the cone and 30-Hz flicker responses were also reduced, and their implicit times were prolonged. Three weeks after admission, the patient's serum zinc level recovered to normal levels, but his serum vitamin A level was still low. The symptoms of night blindness were gone, and the rod ERGs and single bright-flash responses were within normal limits. However, the cone ERGs and 30-Hz flicker responses were still depressed. CONCLUSIONS: The recovery of scotopic function together with the recovery of zinc but not vitamin A levels suggests that the ERG changes were most likely related to low zinc levels.
BACKGROUND: There is conflicting evidence as to whether ursodeoxycholic acid (UDCA) reduces the incidence of parenteral nutrition-associated cholestasis. AIM: To investigate the efficacy of UDCA on parenteral nutrition-associated cholestasis in children with intestinal failure due to short bowel syndrome or to other causes. METHODS: Children with cholestasis received 30 mg/kg/day UDCA. Improvement or normalization of parenteral nutrition-associated cholestasis was evaluated at 6 months of therapy and at the last follow-up. In a subgroup of children, serum UDCA levels were measured while receiving UDCA and after 4 weeks withdrawal. RESULTS: Twelve children were treated with UDCA. Full remission or partial improvement of parenteral nutrition-associated cholestasis occurred in 11 of 12 children. In three of four children, withdrawal of UDCA was associated with a rebound rise of cholestasis. Only one of 12 treated children showed no improvement and in this patient, in contrast to four other patients, plasma levels of UDCA did not increase during treatment. CONCLUSIONS: Ursodeoxycholic acid was effective in controlling parenteral nutrition-associated cholestasis. The efficacy of UDCA also in children with short bowel is related to intestinal absorption.