Blaszyk, Hagen and Wild, Peter J. and Oliveira, Andre and Kelly, Darlene G. and Burgart, Lawrence J. (2005) Hepatic copper in patients receiving long-term total parenteral nutrition. JOURNAL OF CLINICAL GASTROENTEROLOGY, 39 (4). pp. 318-320. ISSN 0192-0790,
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Goals: To assess the possibility of iatrogenic hepatic copper overload in adult patients on long-term total parenteral nutrition (TPN). Background: TPN predisposes to hepatic copper accumulation through disturbances of the enterohepatic bile acid pool, but iatrogenic copper overload through TPN solutions may occur as well. Study: Quantitative hepatic copper and multiple clinical, biochemical, and histopathologic parameters were compared between patients with long-term TPN associated liver disease (n = 28) and patients with drug-induced cholestatic liver disease (n = 10). Results: Eighty-nine percent of TPN patients and all controls had mildly elevated hepatic tissue copper, but 29% of TPN patients had levels above the diagnostic threshold for Wilson's disease. Quantitative hepatic copper correlated positively with serum aspartate aminotransferase (P = 0.001, r = 0.59), total bilirubin (P < 0.001, r = 0.65), and direct bilirubin (P < 0.001, r = 0.63) in TPN patients, but not in controls. The amount of hepatic copper did not correlate with the duration of TPN (inedian, 1.9 years; range, 0.3-18.0 years) or serum copper levels. TPN patients with significant cholestasis accumulated more copper than patients with no or only minimal cholestasis (P = 0.002). Conclusions: Significant hepatic copper overload in TPN patients Occurs through chronic cholestasis in TPN-associated liver disease and is independent from the total duration of TPN. latrogenic copper overload through trace elements in TPN solutions does not seem to be a significant factor.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TRACE-ELEMENT CONTAMINATION; LIVER-DISEASE; biliary transporter; cholestasis; liver disease; steatohepatitis; trace elements |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Pathologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 18 May 2021 06:57 |
| Last Modified: | 18 May 2021 06:57 |
| URI: | https://pred.uni-regensburg.de/id/eprint/36307 |
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