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Fecal protoporphyrin excretion in erythropoietic protoporphyria: effect of cholestyramine and bile acid feeding.

Abstract
The effect of cholestyramine and bile acid feeding upon fecal, red blood cell, and plasma protoporphyrin levels was evaluated in a patient with erythropoietic protoporphyria and evidence of hepatic damage. After a basal period on a controlled diet, bile acids alone were administered (300-900 mg) daily for 9 days, followed by cholestyramine (12 g) plus bile acids (900 mg) daily for 7 days, and cholestyramine alone (12 g) daily for 6 days. There was no substantial change in either the red blood cell or plasma protoporphyrin concentrations during any treatment period. However, cholestyramine and cholestyramine combined with bile acids caused a threefold increase in fecal protoporphyrin excretion, whereas bile acids alone had no effect in this regard. After 1 yr of cholestyramine therapy, fecal excretion of protoporphyrin remained elevated with concurrent improvement in liver function tests and photosensitivity. This study indicates that cholestyramine but not bile acids can substantially increase protoporphyrin excretion and therefore may be capable of ameliorating the hepatotoxicity that may occur in selected patients with erythropoietic protoporphyria.
AuthorsA J McCullough, D Barron, K D Mullen, M Petrelli, M C Park, H Mukhtar, D R Bickers
JournalGastroenterology (Gastroenterology) Vol. 94 Issue 1 Pg. 177-81 (Jan 1988) ISSN: 0016-5085 [Print] United States
PMID3335288 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Bile Acids and Salts
  • Porphyrins
  • Protoporphyrins
  • Cholestyramine Resin
Topics
  • Bile Acids and Salts (therapeutic use)
  • Child
  • Cholestyramine Resin (therapeutic use)
  • Feces (analysis)
  • Female
  • Humans
  • Liver Diseases (drug therapy, metabolism)
  • Photosensitivity Disorders (drug therapy, metabolism)
  • Porphyrias (drug therapy, metabolism)
  • Porphyrins (metabolism)
  • Protoporphyrins (metabolism)

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