Transient elevation of urinary catecholamine excretion and cholestatic liver disease in a neonate with...

Hypothalamic hypopituitarism was diagnosed in a 3-month-old boy presenting with cholestatic liver disease, which resolved 5 weeks after the start of replacement therapy with hydrocortisone and human growth hormone. Clinical and pathohistological features of liver disease associated with neonatal hypopituitarism in this patient are compared to those of patients reviewed from the literature. Urinary excretion of dopa and 3-methoxytyramine but not of other catecholamine metabolites was elevated during cholestatic liver disease. 3-Methoxytyramine excretion normalized when cholestasis resolved. Altered hepatic metabolism of catecholamines due to growth hormone and cortisol deficiency may explain this observation.