Successful treatment of an infant with congenital bile acid synthesis disorder type 3 by ursodeoxycholic acid: a case report

• Published in: Journal of medical case reports Vol. 16; no. 1; p. 139
• Main Authors: Mo, Weiqian, Wang, Feng, Zhou, Chuanen, Ma, Tinghe, Pan, Zhaojun, Xie, Min, Ren, Haoyan, Xie, Yongwu
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 07-04-2022; BioMed Central; BMC
• Subjects: Abdomen; Acids; Aspartate; Bile; Bile Acids and Salts; Biopsy; Care and treatment; Case Report; Case reports; Congenital bile acid synthesis disorder; Congenital diseases; CYP7B1 gene; Cysts; Cytochrome P-450; Deoxycholic acid; Development and progression; Diagnosis; Disease; Enzymes; Gallbladder diseases; Genetic aspects; Genetic disorders; Humans; Infant; Kidneys; Liver; Liver Diseases; Male; Metabolic disorders; Metabolites; Mutation; Nervous system; Oxysterol 7α-hydroxylase; Oxysterols; Parents & parenting; Patients; Sepsis; Sinuses; Skin; Ultrasonic imaging; Ursodeoxycholic acid; Ursodeoxycholic Acid - therapeutic use; Ursodiol; China; Congenital bile acid synthesis disorder; Oxysterol 7α-hydroxylase; CYP7B1 gene; Ursodeoxycholic acid
• ISSN: 1752-1947; 1752-1947
• DOI: 10.1186/s13256-022-03365-z

Congenital bile acid synthesis disorder type 3 caused by oxysterol 7α-hydroxylase deficiency is an extremely rare genetic liver disease. As it may cause rapid progression to end-stage liver disease, a high cautiousness in diagnosis and early treatment are required. Here we describe the first case of congenital bile acid synthesis disorder type 3 in China that was confirmed by genetic analysis.
A 5-month-old Chinese male infant suffered skin yellowing since birth. The patient showed significantly increased alanine transaminase, aspartate transaminase, and total and direct bilirubin levels, and enlarged liver at admission. Whole-exome sequencing confirmed homozygous mutation in the CYB7B1 gene that encodes oxysterol 7α-hydroxylase. Ursodeoxycholic acid treatment significantly mitigated the condition of the patient and lowered biochemical indicators. Unfortunately, the patient developed septicemia and gave up treatment.
The patient was successfully treated with ursodeoxycholic acid, which has not been reported previously. Ursodeoxycholic acid replacement therapy is an effective and affordable treatment for congenital bile acid synthesis disorder type 3 caused by oxysterol 7α-hydroxylase deficiency.