Bile Acid Malabsorption as a Cause of Chronic Diarrhea Diagnostic Value of 7α-Hydroxy-4-Cholesten-3-One in Serum
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- Sauter, G.H., Munzing, W., Ritter, C.V. et al. Dig Dis Sci (1999) 44: 14. doi:10.1023/A:1026681512303
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To evaluate the usefulness of7α-hydroxy-4-cholesten-3-one (HCO) serumconcentrations as a diagnostic marker of bile acidmalabsorption, we determined the reference range of HCOin 106 normal subjects (age 40.2 ± 16.8 years; 55 women, 51men) and conducted a utility study in 23 patients withchronic diarrhea of unknown origin (age 49.4 ±15.3 years, 13 women, 10 men). The diagnosis of bileacid malabsorption was made on the basis of a decreased retentionof [75Se]homocholyltaurine after oralapplication (75SeHCAT test). HCO (referencerange: 6-48 ng/ml) and the 75SeHCAT testyielded the same results in 19/23 (83%) patients. Bile acid malabsorption wasidentified by an increase of HCO in serum with asensitivity of 90% and a specificity of 79%. Analysis ofHCO in serum may serve as a novel, simple, and sensitive method for the detection of bile acidmalabsorption in patients with chronic diarrhea ofunknown origin.