A study on cholestasis in infants less than six months of age presenting to Lady Ridgeway Hospital for Children, Colombo

Luthufdeen, Mohamed Infaq Mohamed; Waidyanatha, Samantha

doi:10.4038/sljch.v45i1.8083

Cited by 4 publications

(4 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regarding other findings, this study revealed the same patients by examination and by Abd U/S presented with hepatomegaly (77.1%), which is nearly similar to results of (76.4%) reported by Iranian study [18] (51.7%) respectively with hepatomegaly. Totally (54.3%) of patients presented with splenomegaly depending on U/S finding, which closes to results by MIM Luthufdeen et al [16] (2016) with (56.6%) while the result of N. Urganci et al [10] (2011) and of Dehghani SM.…”

Section: Discussionsupporting

confidence: 87%

Clinical and laboratory evaluation of cholestatic jaundice in a sample of Iraqi infants

2022

MMJ

View full text Add to dashboard Cite

Cholestatic jaundice most probably occurs due to a pathological condition moreover difficult diagnostic problem. The aim of the study: to determine the etiology of cholestatic jaundice in infancy and to evaluate if clinical events and different investigations could assist in the differential diagnosis of intra and extra-hepatic cholestasis. In this hospital-based study analysis of 35 cases diagnosed with cholestatic jaundice aged 3 weeks up to 12 months from two centers carried out from January 2018 to July 2018. Clinical, biochemical, radiological, histopathological results were recorded. Results: Regarding the 35 patients were (54.3% males, 45.7% females), the mean age at presentation was 117.9 ± 86.4 days and mean age at onset of jaundice was 34 ± 59.11 days, All patients were presented with jaundice (100%) and (45.7%) of them were presented with clay color stool, (77.1%) of patients presented with hepatomegaly followed by ( 54.3%) with splenomegaly, regarding the etiology of cholestasis, Extrahepatic biliary atresia was the commonest cause (22.9%) and the most common cause of intrahepatic etiology was Cytomegalovirus (14.3%). While Idiopathic neonatal hepatitis, Alagille syndrome were (8.6%) for each. Progressive familial intrahepatic cholestasis, Galactosemia, Tyrosinemia, and septicemia were (5.7%) for each. Congenital rubella and congenital hypothyroidism and Fatty acid oxidation disorder were (2.9%) for each. Undiagnosed patients represented (14.3%) of all cases. Inconclusion, the etiologies of infantile cholestatic jaundice are numerous. and was no single laboratory investigation that could precisely make a definite diagnosis. Extrahepatic biliary atresia was the most common cause of cholestasis in this study. Jaundice, hepatomegaly, and pale stools were the common clinical features on presentation.

show abstract

Section: Discussionsupporting

confidence: 87%

Clinical and laboratory evaluation of cholestatic jaundice in a sample of Iraqi infants

2022

MMJ

View full text Add to dashboard Cite

show abstract

“…The oral Valganciclovir is a promising drug for CMV infection [10,36,37]. In 84.6% cases of CMV (with Valganciclovir) and 50% cases of CMV with HSV (with Valganciclovir and Acyclovir) improved.…”

Section: Discussionmentioning

confidence: 99%

“…Idiopathic neonatal hepatitis (INH) and biliary atresia (BA) are the most commonly observed causes of cholestatic jaundice in the first months of life [8,9]. Idiopathic, congenital infection, sepsis, and inborn errors of metabolism are relatively more common causes of neonatal hepatitis compared to toxic causes, post-hemolytic states, neonatal acute hepatic necrosis, parenteral nutrition, and chromosomal anomalies as well as familial syndromes [10]. Among Asians, alpha-1 antitrypsin (α1AT) deficiency is uncommon but common among Caucasians [11].…”

Section: Introductionmentioning

confidence: 99%

Etiology and outcome of neonatal cholestasis: an experience in a tertiary center of Bangladesh

Mahmud

Gulshan

Parvez

et al. 2022

Egypt Liver Journal

View full text Add to dashboard Cite

Background Neonatal cholestasis (NC) is a major cause of morbidity and mortality in young infants. This study examines the etiology of NC and its outcome during 2 years of follow-up at a tertiary referral center in Bangladesh. Results Out of 80 cholestatic infants, 60% had intrahepatic cholestasis with a mean age of onset of 12.4±2.8 days and a mean age of admission of 82.4±29.0 days. The remaining 40% were extrahepatic with a mean age of onset of 6.7±2.3 days and a mean age of admission of 94.6±50.4 days. Biliary atresia (BA), idiopathic neonatal hepatitis (INH), and TORCH (Toxoplasma, rubella, cytomegalovirus, and herpes simplex) infection except rubella were the most common causes. After receiving treatment, 46.2% of the cases improved, 23.8% deteriorated with morbidity, and 30% died. The majority of the children with INH, TORCH, choledochal cyst, hypothyroidism, galactosemia, and urinary tract infection (UTI) with sepsis were improved. Significant mortality was found in BA (56.6%), intrahepatic bile duct paucity (PIBD) (100%), and progressive familial intrahepatic cholestasis (PFIC) (100%) whereas the rest of BA (43.4%) live with persistent morbidity. Significant clinical improvement was observed in 37 (46.2%) cases of cholestasis evidenced by decreasing jaundice, change of color of urine from dark to normal color, change of stool color from pale to yellow, and gradual decrease in liver size from hepatomegaly state. In addition, decreasing median total bilirubin, direct bilirubin, alanine transaminase, gamma-glutamyl transferase, and alkaline phosphatase showed biochemical improvement at 2 years follow-up. The age of admission, etiology, and presence of ascites are the predictors of outcomes. Conclusion BA was the most common cause of extrahepatic while INH and TORCH infection were the most common cause of intrahepatic cholestasis. Majority of children with intrahepatic cholestasis improved but deteriorated with BA and genetic causes. Prompt referral and early diagnosis as well as the etiology of NC were the main determinants of the favorable outcome.

show abstract

“…Incidence of neonatal cholestasis or biliary atresia in Sri Lanka (SL) or South Asia is not known. However, it is estimated that biliary atresia accounts for 26-36% of neonatal cholestasis in this region [4].…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors and outcomes of Kasai portoenterostomy (KPE): nine-year experience from a lower-middle income country

2023

View full text Add to dashboard Cite

Outcome data after Kasai Portoenterostomy (KPE) reported worldwide shows considerable regional and institutional variation. It is not known whether the same standards of outcomes reported in western world can be replicated in resource-poor countries. MethodsWe reviewed 79 patients of which 43 had completed a 2-year minimum follow-up. Two cohorts were based on age at KPE. Median age at surgery was 60 days. ResultsClearance of jaundice (COJ) at 3 months was 20.93% and was not affected by age at surgery (p = 0.295).Four patients (9.3%) received liver transplant and 16 patients (37.21%) were recorded dead at a median age of 7 months. Native liver survival (NLS) was 53.49% and Overall survival (OS) was 62.79%. Kaplan-Meier estimated 4-and 6-year NLS were 55.8% and 49.6% respectively. There was a signi cant difference in the NLS between early and late surgery groups. ConclusionWhilst causes for low COJ need to be explored, this data rea rm that early surgery has a signi cant favorable effect on survival. NLS was comparable with data from the developed world whereas low OS is explained by limited access to transplant. Thus, where the survival depends on native liver longevity, emphasis should be on as early KPE as possible.

show abstract

A study on cholestasis in infants less than six months of age presenting to Lady Ridgeway Hospital for Children, Colombo

Cited by 4 publications

References 8 publications

Clinical and laboratory evaluation of cholestatic jaundice in a sample of Iraqi infants

Clinical and laboratory evaluation of cholestatic jaundice in a sample of Iraqi infants

Etiology and outcome of neonatal cholestasis: an experience in a tertiary center of Bangladesh

Prognostic factors and outcomes of Kasai portoenterostomy (KPE): nine-year experience from a lower-middle income country

Contact Info

Product

Resources

About