Relationship between iron deficiency and cholestasis associated with parenteral nutrition

In a study of 22 patients receiving total parenteral nutrition (TPN), we found that iron-deficient patients were less likely to develop cholestasis than patients with normal iron stores. The mean and S.D. of serum iron, total iron binding capacity and percent saturation in the 12 patients developing cholestasis were 12.7 +/- 5.2 micromol/L, 37.1 +/- 8.5 micromol/L and 37 +/- 24% whereas in the 10 patients who did not develop cholestasis, the values were 7.3 +/- 3.6 micromol/L, 54.8 +/- 17.9 micromol/L and 14 +/- 7% respectively. All differences were statistically significant. The relationship between iron stores and TPN-associated cholestasis deserves further study.