ORAL CALCIUM-PHOSPHATE - A NEW THERAPY FOR CRIGLER-NAJJAR-DISEASE

Background & Aims: Calcium phosphate binds unconjugated bilirubin in v itro, and dietary calcium phosphate supplementation reduces the serum bilirubin level in rats with hereditary unconjugated hyperbilirubinemi a (Gunn rats). The aim of this study was to evaluate the effect of ora l calcium phosphate supplementation on plasma bilirubin levels in pati ents with Crigler-Najjar disease. Methods: A placebo-controlled, doubl e-blind, crossover design was used, Eleven patients, 2-42 years of age , participated. The group included 5 patients with type I disease who were all treated with phototherapy and 6 patients with type II disease who were primarily treated with phenobarbital. In addition to plasma bilirubin levels, dietary intake and urinary and fecal excretion of ca lcium and phosphate were evaluated, Results: A modest but significant decrease in serum bilirubin was observed in patients with type I disea se (18% +/- 6%, P = 0.03) but not in patients with type II disease dur ing treatment with calcium phosphate, Urinary output of calcium and ph osphate did not change during the treatment period. Conclusions: Oral calcium phosphate may be a useful adjuvant to phototherapy in Crigler- Najjar type I disease.