Colestase neonatal prolongada: estudo prospectivo

Prado, Elizabeth Teixeira Mendes Livramento; Araújo, María de Fátima; Campos, J. V. M.

doi:10.1590/s0004-28031999000400005

Cited by 5 publications

(5 citation statements)

References 33 publications

(21 reference statements)

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“…There was accordance with the literature concerning the clinical findings, in which jaundice was the main manifestation, followed by acholia and choluria (21) . Birth weight values and the weight during the first medical visit were lower in the group with infectious etiology, possibly reflecting the impaired growth expected in cases of neonatal diseases and congenital infections.…”

Section: Discussionsupporting

confidence: 89%

“…In general, intrahepatic neonatal cholestasis (IHNC) represents 2/3 of the cases of neonatal cholestasis (8,12,15,18,28) . The most common causes of the disease are of infectious origin (25,21,29) . In septicemia, signal and symptom manifestations of hepatic origin represent only one component of the involvement of multiple organs, to which the adequate treatment offers the best chance of recovery (4) .…”

Section: Introductionmentioning

confidence: 99%

“…Any serious bacterial infection during the neonatal period can result in jaundice (26) ; however, there seems to be a more frequent association with urinary tract infections, especially when the bacterium is Escherichia coli (14) . In addition to these infections, others have been observed, such as syphilis, toxoplasmosis, rubella and cytomegalovirus (CMV) (1,11,20,21,22,23) . Despite the many possible etiologies for IHNC (8) , 13%-78% of the cases have been reported to be related to idiopathic etiology (7,10,16,17,18,27) .…”

Section: Introductionmentioning

confidence: 99%

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Clinical and laboratory evaluation of 101 patients with intrahepatic neonatal cholestasis

Bellomo-Brandão

Porta

Hessel

2008

Arq. Gastroenterol.

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-Background -Intrahepatic neonatal cholestasis can be the initial manifestation of a very heterogeneous group of illnesses of different etiologies. Results -According to diagnosis, patients were classified into three groups: group 1 (infectious) n = 24, group 2 (genetic-endocrine-metabolic) n = 21 and group 3 (idiopathic) n = 56. There were no significant differences in relation to the variables: age, gender, stature at birth, jaundice, acholia/hipocholia, choluria, hepatomegaly, splenomegaly, AST, ALT, ALP, GGT, DB and albumin. Significant differences were observed in relation to the following variables: birth weight and weight during the first medical visit. Birth weight of group 1 was lower in relation group 2 and 3. Weight during the first medical visit followed the same pattern. There was a statistically significant difference in relation to the INR, as the patients of the group 2 presented higher values in relation to groups 2 and 3, despite the median was still pointing out normal values. Conclusions -There were no significant differences in relation to age, gender, stature at birth, jaundice, acholia/hipocholia, choluria, hepatomegaly, splenomegaly, AST, ALT, ALP, GGT, BD and albumin. Birth weight and the weight during the first medical visit were lower in the group with infectious etiology. In addition, a significant difference in INR reflected impaired coagulation of patients of the group of the genetic-endocrine-metabolic disease.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical and laboratory evaluation of 101 patients with intrahepatic neonatal cholestasis

Bellomo-Brandão

Porta

Hessel

2008

Arq. Gastroenterol.

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“…It has been already known for sometime that this virus is a participant in the etiopathogenesis of neonatal hepatitis (16,17) , but only recently it has been indicated as a possible etiologic factor in EHBA (4,24) . CHANG et al (3) , used the polymerase chain reaction (PCR) to study CMV in liver tissue of children with neonatal cholestasis and it was found that out of 50 children with IHC, 23 children were positive and in 26 children with EHBA, only 2 were positive.…”

Section: Discussionmentioning

confidence: 99%

Infection by cytomegalovirus in patients with neonatal cholestasis

Oliveira

Kanawaty

Costa

et al. 2002

Arq. Gastroenterol.

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-Background -Neonatal cholestasis syndrome with an intra or extrahepatic origin has been associated to viral infections. The participation of the cytomegalovirus in the etiopathogenesis of neonatal hepatitis has been already known for some time, but only recently there have been indications that this virus may be one of the possible etiological factors for extrahepatic biliary atresia. Aims -To assess the prevalence of infection by cytomegalovirus in patients with intrahepatic cholestasis and extrahepatic cholestasis. To compare the clinical characteristics of the intrahepatic cholestasis and extrahepatic cholestasis groups with the cytomegalovirus serological results. Patients and Methods -This study consisted of 76 patients with neonatal cholestasis who were admitted between January 1980 and January 1999 when they underwent a cytomegalovirus serologic study using the ELISA method. A case note was kept on each patient with the following data: age of patient at admission, serologic result for cytomegalovirus, history of maternal infection, prematurity, fetal distress, birth weight, ponderal gain, choluria and fecal acholia. The final anatomic diagnosis of cholestasis was based on the results of an abdominal ultrasonography, a liver biopsy and its evolution. The patients were then divided into two groups: group I -intrahepatic cholestasis and group II -extrahepatic cholestasis. Each of these groups were then divided into two subgroups: subgroup Apositive serology (IgM) for cytomegalovirus and subgroup B -negative serology (IgM) for cytomegalovirus. Results -The frequency of positive serology (IgM) for cytomegalovirus was 29.4% in children with intrahepatic cholestasis and 28.5% in children with extrahepatic cholestasis. In comparison with group IIB, group IIA presented a higher rate of maternal infection history. The patients in group IIA demonstrated a delayed access to the service in comparison with group IA. The groups did not demonstrate any significant differences regarding the onset age of jaundice, choluria and fecal acholia, birth weight and ponderal gain. Conclusions -The positive (IgM) seroprevalence for cytomegalovirus in children with intrahepatic cholestasis and extrahepatic cholestasis is high. The history of maternal infection was more common in extrahepatic cholestasis patients with positive serology for cytomegalovirus. There was a delay in the referral of these patients which resulted in a late diagnosis and surgical treatment.

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“…Neonatal intrahepatic cholestasis (NIHC) represents 2/3 of the cases of neonatal cholestasis [5][6][7][8][9] . The most common causes of the disease are infection, including cytomegalovirus (CMV) [10][11][12] . Data on the prevalence of CMV in NIHC vary greatly depending on the diagnostic method used (5%-46%) [2,[12][13][14] .…”

Section: Introductionmentioning

confidence: 99%

Cytomegalovirus frequency in neonatal intrahepatic cholestasis determined by serology, histology, immunohistochemistry and PCR

Bellomo-Brandão¹,

Andrade²,

Costa³

et al. 2009

WJG

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AIM:To determine cytomegalovirus (CMV) frequency in neonatal intrahepatic cholestasis by serology, histological revision (searching for cytomegalic cells), immunohistochemistry, and polymerase chain reaction (PCR), and to verify the relationships among these methods. METHODS:The study comprised 101 non-consecutive infants submitted for hepatic biopsy between March 1982 and December 2005. Serological results were obtained from the patient's files and the other methods were performed on paraffin-embedded liver samples from hepatic biopsies. The following statistical measures were calculated: frequency, sensibility, specific positive predictive value, negative predictive value, and accuracy. RESULTS:T he fre que nc ie s o f po s i t ive re s u l t s were as follows: serology, 7/64 (11%); histological revision, 0/84; immunohistochemistry, 1/44 (2%), and PCR, 6/77 (8%). Only one patient had positive immunohistochemical findings and a positive PCR. The following statistical measures were calculated between PCR and serology: sensitivity, 33.3%; specificity, 88.89%; positive predictive value, 28.57%; negative predictive value, 90.91%; and accuracy, 82.35%. CONCLUSION:The frequency of positive CMV varied among the tests. Serology presented the highest positive frequency. When compared to PCR, the sensitivity and positive predictive value of serology were low.

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Colestase neonatal prolongada: estudo prospectivo

Cited by 5 publications

References 33 publications

Clinical and laboratory evaluation of 101 patients with intrahepatic neonatal cholestasis

Clinical and laboratory evaluation of 101 patients with intrahepatic neonatal cholestasis

Infection by cytomegalovirus in patients with neonatal cholestasis

Cytomegalovirus frequency in neonatal intrahepatic cholestasis determined by serology, histology, immunohistochemistry and PCR

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