Clinical and laboratory evaluation of 101 patients with intrahepatic neonatal cholestasis

Bellomo-Brandão, Maria Ângela; Porta, Gilda; Hessel, Gabriel

doi:10.1590/s0004-28032008000200012

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…Ponto de corte: número de vezes acima de GGT > 10,80. O peso e o comprimento ao nascer foram mais baixos no grupo com CIH, possivelmente refletindo prematuridade, insuficiência de crescimento, complicações neonatais, distúrbios metabólicos e infecções congênitas 8,14,19,22,23 .…”

Section: Discussionunclassified

Differential diagnosis of neonatal cholestasis: clinical and laboratory parameters

Bellomo-Brandão¹,

Arnaut²,

Tommaso³

et al. 2010

J Pediatr (Rio J)

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Objective: To evaluate if clinical and laboratory parameters could assist in the differential diagnosis of intra and extra-hepatic neonatal cholestasis (NC). Methods: Retrospective study of NC patients admitted at the Pediatric Hepatology Outpatient Clinic of the teaching hospital of Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil, between December 1980 and March 2005. The approach to the diagnosis of NC was standardized. According to diagnosis, patients were classified into two groups: I (intra-hepatic neonatal cholestasis) and II (extra-hepatic neonatal cholestasis). In order to verify if there was association with the categorical variable, the chi-square and Mann-Whitney tests were used, with corrections for age for the covariance analysis (ANCOVA). The determination of accuracy of the clinical and laboratory variables for differentiation of the groups was made using the analysis of the ROC curve. Results: One hundred and sixty-eight patients were evaluated (group I = 54.8% and group II = 45.2%). In the patients with less than 60 days of life there was predominance of intra-hepatic causes, whereas, in those older than 60 days, there was predominance of extra-hepatic etiology (p < 0.001). Median birth weight was lower in group I (p = 0.003), as well as length at birth (p = 0.007). Median values of direct bilirubin were higher in group II (p = 0.006). Values of gamma-glutamyltransferase (GGT) (10 times higher than the limit of normality) presented sensitivity of 56.3%, specificity of 91.5%, and accuracy of 75.7% for the diagnosis of extra-hepatic cholestasis. Conclusion: In the present study, extra-hepatic NC presented greater weight and length at birth, fecal hypocholia/ acholia, choluria, hepatomegaly, increase in GGT (10.8 times higher than the limit of normality), and a delay for investigation in the tertiary center. J Pediatr (Rio J). 2010;86(1):40-44: Neonatal cholestasis, children, hepatitis.

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Section: Discussionunclassified

Differential diagnosis of neonatal cholestasis: clinical and laboratory parameters

Bellomo-Brandão¹,

Arnaut²,

Tommaso³

et al. 2010

J Pediatr (Rio J)

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“…8,14,19,22,23 The median age of infants at the time of referral is a cause for concern. In the EHC group, age at referral was over 60 days (77 days) of life and higher than that in the IHC group.…”

Section: Discussionmentioning

confidence: 99%

Diagnóstico diferencial de colestase neonatal: parâmetros clínicos e laboratoriais

Bellomo-Brandão¹,

Arnaut²,

Tommaso³

et al. 2010

J. Pediatr. (Rio J.)

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Objective: To evaluate if clinical and laboratory parameters could assist in the differential diagnosis of intra and extra-hepatic neonatal cholestasis (NC). Methods:Retrospective study of NC patients admitted at the Pediatric Hepatology Outpatient Clinic of the teaching hospital of Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil, between December 1980 and March 2005. The approach to the diagnosis of NC was standardized. According to diagnosis, patients were classified into two groups: I (intra-hepatic neonatal cholestasis) and II (extra-hepatic neonatal cholestasis). In order to verify if there was association with the categorical variable, the chi-square and Mann-Whitney tests were used, with corrections for age for the covariance analysis (ANCOVA). The determination of accuracy of the clinical and laboratory variables for differentiation of the groups was made using the analysis of the ROC curve. Results:One hundred and sixty-eight patients were evaluated (group I = 54.8% and group II = 45.2%). In the patients with less than 60 days of life there was predominance of intra-hepatic causes, whereas, in those older than 60 days, there was predominance of extra-hepatic etiology (p < 0.001). Median birth weight was lower in group I (p = 0.003), as well as length at birth (p = 0.007). Median values of direct bilirubin were higher in group II (p = 0.006). Values of gamma-glutamyltransferase (GGT) (10 times higher than the limit of normality) presented sensitivity of 56.3%, specificity of 91.5%, and accuracy of 75.7% for the diagnosis of extra-hepatic cholestasis. Conclusion:In the present study, extra-hepatic NC presented greater weight and length at birth, fecal hypocholia/ acholia, choluria, hepatomegaly, increase in GGT (10.8 times higher than the limit of normality), and a delay for investigation in the tertiary center.J Pediatr (Rio J). 2010;86(1):40-44: Neonatal cholestasis, children, hepatitis.

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“…Se produce por una obstrucción del fl ujo a través del árbol biliar intra o extrahepático, que ocasiona un acumulo de substancias que se excretan normalmente en la bilis. Suele presen-tarse con ictericia prolongada, orina oscura, heces pálidas, hepatomegalia y prurito dentro de las primeras 4 semanas de vida (2,3). El término colestasis neonatal involucra el período del recién nacido hasta los 3 meses de edad (1,4).…”

Section: Introductionunclassified

Colestasis neonatal: reporte de 21 casos en un hospital infantil de Cartagena, Colombia

Jose

Vivero

et al. 2015

Rev. Colomb. Gastroenterol.

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La colestasis es una alteración en el flujo biliar que se presenta por la disminución o el cese de excreción biliar. En la actualidad, son pocos los estudios en Colombia sobre esta patología. Se presentan 21 casos de colestasis neonatal en un hospital infantil de la ciudad de Cartagena (Colombia) entre 2010 y 2013, con el objetivo de caracterizar la etiología y clínica de la enfermedad. Se seleccionaron los pacientes entre 0 y 3 meses de edad con bilirrubina directa >2 mg/dL. En este estudio se encontró que según el género, el 52,4% fueron de sexo masculino y el 47,6%, de sexo femenino. La edad gestacional predominante fue a término en el 76,2% y sin antecedentes perinatales en el 57,1%. Los hallazgos clínicos se presentaron en los primeros 30 días de nacido en un 71% y 4 pacientes fueron remitidos a trasplante hepático. La etiología más frecuente fue de tipo infeccioso en 13 de los pacientes estudiados y 4 pacientes se relacionaron con atresias. La causa más frecuente de colestasis neonatal en este estudio resultó estar asociada con etiologías infecciosas. Sin embargo, las alteraciones obstructivas, como la atresia de vías biliares, siguen ocupando un renglón impor- tante y requieren un estudio y manejo prioritario, dado su mejor pronóstico relacionado con la intervención temprana.

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Clinical and laboratory evaluation of 101 patients with intrahepatic neonatal cholestasis

Cited by 7 publications

References 18 publications

Differential diagnosis of neonatal cholestasis: clinical and laboratory parameters

Differential diagnosis of neonatal cholestasis: clinical and laboratory parameters

Diagnóstico diferencial de colestase neonatal: parâmetros clínicos e laboratoriais

Colestasis neonatal: reporte de 21 casos en un hospital infantil de Cartagena, Colombia

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