The changes in esterified serum cholesterol and its fractions (separation by thi~-layer chromatography) were studied in 31 children (aged between 2 and 12 years) with infectious hepatitis. The results can be summarized as follows:
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The significant fall in esterified cholesterol in the acute stage of the disease is due to a decrease of all fraction~. However, in just under half the number of patients there was a greater decrease in cholesterol linoleate.
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Therefore the normal relative values in the composition of cholesterol esters were observed in 55 per cent of the cases, while in 45 per cent of the patient~ the percentage of cholesterol linoleate was found to be significantly lower, thus causing a relative increase of the other fractions.
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These differences within the hepatitis group were no longer demonstrable after the third week from the onset of the disease. The ratio cholesterol ester: total cholesterol returned to normal values; however, the absolute values of the various fractions were still lower than the corresponding levels in normal children with the exception of monoenes. Also the percentage in the distribution of cholesterol ester showed further deviation, since the percentage of linoleate was decreased in all groups. 0nly in five patients who were on a normal, instead of a "liver" diet --even during the acute stage of hepatitis --did not show any significant difference in the percentage of cholesterol linoleate compared to the normal control group.
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An increase in the concentration of free cholesterol, which occurred in 61.3 per cent of all eases augmented the reduction in the ratio cholesterol ester: total cholesterol and resulted in slightly increased total cholesterol values. It is suggested that the reduced capacity for esterification in the damaged liver is responsible for the sharp drop in esterified cholesterol, while the decrease in cholesterol linoleate may be partly caused by an insufficient supply of fat.