An inborn error of bile acid synthesis (3beta-hydroxy-delta5-C27-steroid dehydrogenase deficiency) presenting as malabsorption leading to rickets

Arch Dis Child. 1999 May;80(5):463-5. doi: 10.1136/adc.80.5.463.

Abstract

Deficiency of 3beta-hydroxy-delta5-C27-steroid dehydrogenase (3beta-HSDH), the enzyme that catalyses the second reaction in the principal pathway for the synthesis of bile acids, has been reported to present with prolonged neonatal jaundice with the biopsy features of neonatal hepatitis. It has also been shown to present between the ages of 4 and 46 months with jaundice, hepatosplenomegaly, and steatorrhoea (a clinical picture resembling progressive familial intrahepatic cholestasis). This paper reports two children with 3beta-HSDH deficiency who developed rickets during infancy and did not develop clinically evident liver disease until the age of 3 years. Bile acid replacement resulted in considerable clinical and biochemical improvement. The importance of thorough investigation of fat soluble vitamin deficiencies in infancy is emphasised.

Publication types

  • Case Reports

MeSH terms

  • 3-Hydroxysteroid Dehydrogenases / deficiency*
  • Bile Acids and Salts / biosynthesis*
  • Female
  • Humans
  • Infant
  • Liver Diseases / etiology
  • Male
  • Metabolism, Inborn Errors / complications*
  • Rickets / etiology*

Substances

  • Bile Acids and Salts
  • 3-Hydroxysteroid Dehydrogenases
  • delta(5)-3 beta-hydroxysteroid dehydrogenase