Glucuronidated and sulfated bile acids in serum of patients with acute hepatitis

The concentrations of glucuronidated and sulfated bile acids in the serum of 15 patients with acute hepatitis were determined by mass fragmentography. Total serum bile acid levels were 13.79-444.10 mumol/liter, and the percentages of glucuronidated and sulfated bile acids were in the wide ranges of 1.7-33% and 2.4-49%, respectively. In four of the five patients for whom serum bile acids were analyzed serially from the acute to the recovery stages of acute hepatitis, the decrease of the glucuronidated and sulfated bile acids was slower than that of nonglucuronidated, nonsulfated bile acids. Thus, the relative proportion of the glucuronides and sulfates in total bile acids apparently increased during the recovery phase. The mechanism for the relative predominance of bile acid esters in serum during recovery is unknown but might reflect an improved excretion of the nonesterified bile acids into bile after the rapid recovery of intrahepatic cholestasis.