Hepatitis syndrome in infancy--an epidemiological survey with 10 year follow up.

Dick, Moira; Mowat, Alex P.

doi:10.1136/adc.60.6.512

Cited by 127 publications

(81 citation statements)

References 16 publications

(1 reference statement)

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“…Since many metabolic disorders have favorable outcome by early treatment, they should be kept in mind for any critically ill newborn infants. An interesting finding in this series was that AAT deficiency was not determined, whereas it is reported to account for approximately 13% of all cholestatic infants (4,22). This may be due to low carrier count in the Turkish population, although there is no available data, and also phenotype determination is not routinely used beyond serum ATT level measurement and histological examination of liver tissue.…”

Section: Discussionmentioning

confidence: 84%

“…The main concern regarding neonatal cholestasis has recently been concentrated on understanding the pathogenesis of cholestatic disease, developing diagnostic tests and therapeutic agents for chronic cholestatic liver disease (2). However, the etiology of cholestasis in newborns at intensive care settings has a spectrum different from that reported in epidemiological studies (4,6), and is usually on multifactorial basis (7)(8)(9)(10)(11). In this population, common perinatal events such as perinatal hypoxia, parenteral nutrition, sepsis, poor enteral feeding, and cardiovascular collapse can contribute to the development of cholestasis (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19), in addition to the structurally and functionally immature biliary tract (1,8).…”

mentioning

confidence: 85%

“…Neonatal cholestasis was reported to occur 1 in 2500-5000 infants, and extrahepatic biliary atresia and neonatal hepatitis were diagnosed in the majority of cases (4)(5)(6). The portion of the category known as an idiopathic neonatal cholestasis has decreased with improving ability to diagnose specific conditions over the past two decades (1,2).…”

mentioning

confidence: 99%

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Conjugated hyperbilirubinemia in the neonatal intensive care unit

Ipek¹,

Aydın²,

Zencıroğlu³

et al. 2013

Turk J Gastroenterol

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Section: Discussionmentioning

confidence: 84%

mentioning

confidence: 85%

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Conjugated hyperbilirubinemia in the neonatal intensive care unit

Ipek¹,

Aydın²,

Zencıroğlu³

et al. 2013

Turk J Gastroenterol

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“…The frequency of cholestatic jaundice is difficult to deter mine, varying between 1:2500 and 1:5000 newborns [1][2][3] . The initial objective in the management of neonatal cholestatic jaundice is to distinguish between intrahepatic and extrahepatic causes, as the latter requires urgent surgical intervention [4] .…”

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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“…[1][2][3] The frequency of NC in the population is difficult to evaluate. Incidences of 1/2,500, 4 1/5,000, 5 and 1/9,000 6 live births have been recorded in the literature. The focus of the initial approach is to differentiate between intrahepatic (IHC) and extrahepatic (EHC) cholestasis.…”

Section: Introductionmentioning

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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Hepatitis syndrome in infancy--an epidemiological survey with 10 year follow up.

Cited by 127 publications

References 16 publications

Conjugated hyperbilirubinemia in the neonatal intensive care unit

Conjugated hyperbilirubinemia in the neonatal intensive care unit

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

Diagnóstico diferencial de colestase neonatal: parâmetros clínicos e laboratoriais

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