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Background: Tetrahydroxy bile acids present at negligible or undetectable levels in healthy human adults but present at elevated levels in urine of infants with cholestasis clinically are the most valued marker of cholestasis next to serum tests. Methods: Twenty subjects with cholestasis, age range between seven days and one year, the study measured urinary tetrahydroxy bile acids for all cases. Results: Study found the presence of urinary tetrahydroxy bile acids in new-borns and infants with infantile cholestasis.New-borns and infants with a good prognosis had higher tetrahydroxy bile acids levels than those with a poor prognosis according to their outcomes. Conclusion:The study found the incidence of urinary tetrahydroxy bile acids in new-borns and infants with infantile intra-hepatic and extra-hepatic cholestasis. Extra-hepatic cholestatic patients had higher tetrahydroxy bile acids urine level than intra-hepatic, Cytomegalovirus and idiopathic neonatal hepatitis patients had a lesser tetrahydroxy bile acids level than in patients with genetic cholestasis. Tetrahydroxy bile acids play a role in clinical managing and treatment, in addition to their possible defensive properties against hepatic injury.

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