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Byler’s syndrome
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  1. Denver-Aurora Pathology Associates
  2. 1719 East 19th Avenue
  3. Denver, CO 80218, USA
  4. Departments of Pathology, Pediatrics*, and Pediatric Gastroenterology**
  5. Children’s Hospital of Pittsburgh
  6. Pittsburgh, PA, USA
  7. Division of Pediatric Gastroenterology
  8. Rainbow Babies and Children’s Hospital
  9. Cleveland, OH, USA
    1. R M AGOSTINI,
    2. B J ZITELLI

      *

      ,
    3. S A KOCOSHIS

      **

    1. Denver-Aurora Pathology Associates
    2. 1719 East 19th Avenue
    3. Denver, CO 80218, USA
    4. Departments of Pathology, Pediatrics*, and Pediatric Gastroenterology**
    5. Children’s Hospital of Pittsburgh
    6. Pittsburgh, PA, USA
    7. Division of Pediatric Gastroenterology
    8. Rainbow Babies and Children’s Hospital
    9. Cleveland, OH, USA
      1. J T BOYLE
      1. Denver-Aurora Pathology Associates
      2. 1719 East 19th Avenue
      3. Denver, CO 80218, USA
      4. Departments of Pathology, Pediatrics*, and Pediatric Gastroenterology**
      5. Children’s Hospital of Pittsburgh
      6. Pittsburgh, PA, USA
      7. Division of Pediatric Gastroenterology
      8. Rainbow Babies and Children’s Hospital
      9. Cleveland, OH, USA

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        Editor,—The report of Byler’s syndrome with raised sweat electrolytes in an Irish traveller kindred1interests us, as we have observed raised sweat electrolytes in two members of the original Byler kindred who have Byler’s disease. Neither has cystic fibrosis; both underwent liver transplantation in their second decade and subsequently developed pancreatic disease. One has had recurrent pancreatitis and the other has a fibrotic pancreas with exocrine insufficiency.2 In the children without Byler’s disease whom we attend, pancreatic disease after liver transplantation is not usual. Have affected traveller children, particularly older ones, had pancreatitis?

        We can provide additional information on the sister and brother with progressive familial intrahepatic cholestasis and raised sweat electrolytes referred to by Bourke et al 1 and described …

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