Serum hepatic enzyme and bilirubin elevations during parenteral nutrition.

摘要: Serial liver enzyme and bilirubin concentrations were measured in 100 patients undergoing total parenteral nutrition. Between the eighth tenth days, serum glutamic-pyruvic transaminase levels rose to 5.4 times pretotal nutrition levels; glutamic-oxalacetic transaminase, 2.8 times; bilirubin, 2.3 times, lactic dehydrogenase, 1.5 times. These elevations transient, lasting four ten days. Biopsies of taken during maximal demonstrated marked periportal fatty change. A second elevation alkaline phosphatase dehydrogenase occurred one-third one-half those receiving for longer than a 20 day period. more prolonged, no biopsies taken. Amino acid solutions contain conversion products tryptophan, an amino that is unstable presence preservative sodium bisulfite which added all commercially available protein solutions. Infusion these into rats, either alone or as part solutions, resulted change livers identical seen our toxic effect tryptophan proposed.