Parenteral nutrition-associated cholestasis (PNAC) is a condition that occurs when a person receives long-term parenteral nutrition (PN) and develops a blockage in the bile ducts. This blockage can lead to a buildup of bile acids in the liver, which can cause liver damage and other complications. Symptoms of PNAC include jaundice, itching, dark urine, and pale stools. Treatment typically involves discontinuing PN and providing supportive care.

Symptoms of Parenteral Nutrition-Associated Cholestasis (PNAC) include:

-Jaundice
-Itching
-Dark urine
-Light-colored stools
-Abdominal pain
-Nausea
-Vomiting
-Loss of appetite
-Fatigue
-Weight loss

1. Impaired bile flow due to prolonged use of parenteral nutrition.
2. Excessive fat emulsions in the parenteral nutrition solution.
3. Excessive intake of certain micronutrients, such as copper, zinc, and iron.
4. Impaired liver function due to underlying liver disease.
5. Impaired absorption of fat-soluble vitamins due to malabsorption syndromes.
6. Infection or inflammation of the biliary tract.
7. Use of certain medications, such as antibiotics, antifungals, and anticonvulsants.
8. Immune-mediated reactions to components of the parenteral nutrition solution.

1. Discontinuation of parenteral nutrition: This is the most important treatment for Parenteral nutrition-associated cholestasis.

2. Vitamin K supplementation: Vitamin K supplementation may be used to reduce the risk of bleeding due to decreased clotting factors.

3. Ursodeoxycholic acid (UDCA): UDCA is a bile acid that can help reduce the levels of bile acids in the blood and improve liver function.

4. Antioxidants: Antioxidants such as vitamin E, selenium, and N-acetylcysteine may be used to reduce oxidative stress and improve liver function.

5. Probiotics: Probiotics may be used to reduce the risk of infection and improve gut health.

6. Intravenous immunoglobulin (

1. Prolonged duration of PN
2. High dextrose concentration
3. High lipid concentration
4. Low calcium concentration
5. Low magnesium concentration
6. High osmolarity
7. High volume of PN
8. Low albumin levels
9. High bilirubin levels
10. High triglyceride levels
11. Low zinc levels
12. High phosphorus levels
13. Low vitamin E levels
14. Low vitamin K levels
15. Low selenium levels
16. Low copper levels
17. Low iron levels
18. Low vitamin A levels
19. Low vitamin D levels
20. Low vitamin B12 levels
21. Low folate levels
22. Low carnitine levels
23. Low glutamine levels
24. Low arginine levels
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Yes, there are medications available to treat Parenteral nutrition-associated cholestasis. These medications include Ursodeoxycholic acid (UDCA), which helps to reduce bile acid levels, and Vitamin K, which helps to reduce the risk of bleeding. Additionally, some doctors may recommend a low-fat diet and/or a change in the type of parenteral nutrition being used.