Cholestatic Jaundice in Infants  An Experience in Tertiary Care Hospital

Chowdhury, FR; Chowdhury, Kona; Karim, Asm Bazlul

doi:10.3329/jbcps.v32i1.21029

Cited by 5 publications

(5 citation statements)

References 9 publications

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“…In this study of total 35 cases, the mean age at their presentation was 117.9 ± 86.4 days, this goes with FR Chowdhury et al study [8] (2014) which found out the mean age was 111.9±21.14 days in line with same inclusion criteria, but disagrees with Malaysian study (9) (2010) done by WS Lee et al with a mean of (58 days) and with Turkish study [9] (2011) done by Urgancı et al with mean age (60 ± 26 days) and this might due to conduction smaller range of age (16 to 260 days) for Malaysian study and (15 to 240 days) for Turkish study and might due higher awareness in their population and the primary health care. In this study, the age at onset of jaundice is (ranging one to 300) days with a mean of 34 ± 59.11 days, while the Turkish study [10] This depends on Mothers observation and might be explained by the types of IHC cases in the Turkish study that might be presented later in infancy [11,12].…”

Section: Discussionsupporting

confidence: 86%

“…In this study, eight patients (53.3%) who presented with clay color stool were diagnosed with the extrahepatic cause of cholestasis with a significant association (P= 0.001). Regarding associated anomalies, the highest prevalence of intrahepatic etiology of cholestasis was seen among patients with associated anomalies (89.5%) with a significant association (P= Table (8) shows the association between U/S finding and etiology of cholestasis. The highest proportion of extrahepatic cause of cholestasis was found in patients with hepatomegaly (36.4%) with a significant association (P= 0.046).…”

Section: Tablementioning

confidence: 92%

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

2022

MMJ

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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.

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Section: Discussionsupporting

confidence: 86%

Section: Tablementioning

confidence: 92%

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

2022

MMJ

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“…Total serum bilirubin rarely exceeds 12mg/dl in infants with biliary atresia even with complete obstruction of bile duct, where as it may exceed 20mg/dl in those with Neonatal Hepatitis. 8 In the study done by karim et al, 9 mean Total serum bilirubin was 10.4 mg/dl in Extra Hepatic Biliary Atresia babies and 14.1mg/dl in those with NH group. In our study, mean total serum bilirubin value was 12.1±5 in infants with EHBA and 11.7±5.8 in those with NH with p value = 0.379 which was not statistically significant.…”

Section: Discussionmentioning

confidence: 89%

Clinic-o-etiological profile of cholestasis in infants in a tertiary care center

Kumar,

Rani,

Male

2023

PJMS

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Common presenting feature of hepatobiliary and metabolic dysfunction in neonates is cholestatic jaundice. It is essential to recognise the neonatal cholestasis early. Significant proportion of cases of cholestatic disease are constituted by EHBA. If management of Extra Hepatic Biliary Atresia is delayed beyond three months of life, only option available then is liver transplantation.To analyse etiological factors and to study clinical presentation of cases presenting with cholestasis.Study the clinical presentation and analyse the etiological factors in infants with cholestasis. To determine the validity of ACS and compare outcomes of EHBA with respect to age at presentation.Prospective observational study was done in 104 infants with cholestasis who were admitted in Paediatric ward of niloufer hospital from January 2019 to July 2020.Statistical analysis done by chi square test and fisher’s exact tests.Of the total 104 cases, 47 cases were diagnosed to be EHBA and 38 cases were found to have neonatal hepatitis.58.6% were male and 41.34%were female and 72 were term and 32 were preterm. Mean age of presentation with EHBA and Neonatal hepatitis was 91 days and 94 days. LFT’s in EHBA cases showed mean TSB 12.19 ± 5 mg/dl Vs 11.7 ± 5.8 mg/dl in NH babies with a p value equal to 0.379. Direct bilirubin revealed 6.44 ± 3.1mg/dl Vs 6.64 ± 3.1mg/dl in NH group (p = 0.824).HIDA scan showed 41% had EHBA, 33.3% had NH AIIMS Clinical score (ACS) cannot correctly differentiate EHBA from NH.Survival was significantly higher in infants with EHBA who were operated before 60 days of life.

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“…Additionally, 86.0% of patients had persistent pale stools. A previous study similarly reported that 88.2% of patients with BA had persistent pale stool [ 22 ]. Additionally, Karim and Kamal [ 18 ] reported that 81.3% of patients with BA had persistent pale stool.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study Between Cytomegalovirus Immunoglobulin M-Positive and CMV Immunoglobulin M-Negative Biliary Atresia in Infants Attending a Tertiary Care Hospital in Bangladesh

Akter

Karim

Mazumder

et al. 2022

Pediatr Gastroenterol Hepatol Nutr

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Purpose Perinatal cytomegalovirus (CMV) infection can lead to biliary atresia (BA) in different entities. This study aimed to compare the clinical, hematological, biochemical, and histological features of infants with BA based on their CMV immunoglobulin M (IgM) status at presentation. Methods This cross-sectional descriptive study was carried out between January 2019 and June 2020 at the Department of Pediatric Gastroenterology and Nutrition at the Bangabandhu Sheikh Mujib Medical University (BSMMU) in Dhaka. Forty-three patients with BA were selected purposively and categorized into either the CMV IgM-positive or CMV IgM-negative BA group. Categorical variables were compared using Fisher’s exact test and chi-square tests, while the Student’s t -test and Mann–Whitney U-test were used to compare continuous variables. For all statistical tests, a p -value <0.05 was considered statistically significant. Results Thirty-three (76.7%) of the cases were between 2 and 3 months of age on admission. The clinical, hematological, and biochemical parameters did not differ significantly between the CMV IgM-positive and CMV IgM-negative BA groups. Most (50.0%) of the CMV IgM-positive cases had fibrosis stage F2, while 43.5% of the CMV IgM-negative cases had fibrosis stage F3, with no significant difference between the groups ( p =0.391). Conclusion Our data shows no significant distinction between CMV IgM-positive and CMV IgM-negative BA, suggesting that CMV does not contribute to BA pathogenesis.

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Cholestatic Jaundice in Infants An Experience in Tertiary Care Hospital

Cited by 5 publications

References 9 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

Clinic-o-etiological profile of cholestasis in infants in a tertiary care center

A Comparative Study Between Cytomegalovirus Immunoglobulin M-Positive and CMV Immunoglobulin M-Negative Biliary Atresia in Infants Attending a Tertiary Care Hospital in Bangladesh

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Cholestatic Jaundice in Infants  An Experience in Tertiary Care Hospital

Cited by 5 publications

References 9 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

Clinic-o-etiological profile of cholestasis in infants in a tertiary care center

A Comparative Study Between Cytomegalovirus Immunoglobulin M-Positive and CMV Immunoglobulin M-Negative Biliary Atresia in Infants Attending a Tertiary Care Hospital in Bangladesh

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Cholestatic Jaundice in Infants An Experience in Tertiary Care Hospital