The Clinicopathological Parameters for Making the Differential Diagnosis of Neonatal Cholestasis

Content Provider	Semantic Scholar
Author	Lee, Heejin Kang, Jun Kim, Kyung Mo Jang, Joo Young Jang, Se Jin Yu, Eunsil
Copyright Year	2009
Abstract	Background : The diseases that cause neonatal cholestasis display several overlapping clinical feature. Making the differential diagnosis using liver biopsy specimens from infants with neonatal cholestasis is important for delivering the proper treatment. Methods : We assessed the clinical manifestations, laboratory data, and histopathologic features of the pretreatment liver biopsy specimens from patients suffering with biliary atresia (n=66), intrahepatic bile duct paucity (n=15), and neonatal hepatitis (n=21). Results : The gender distribution was nearly equal for the patients with biliary atresia and intrahepatic bile duct paucity, whereas males predominated for the cases of neonatal hepatitis. Only the gamma-glutamyl transferase level differed significantly amongst the groups. The diagnostic features for making the differential diagnosis of bile duct lesions included marked bile ductular proliferation, severe fibrosis, and bile duct loss. The difference of the average percentage of portal tracts with bile duct loss was statistically significant between the patients with intrahepatic bile duct paucity (73.9%) and those patients with neonatal hepatitis (39.1%) (p<0.001). Conclusions : Bile ductular proliferation, bile duct loss, and advanced fibrosis are useful for the differential diagnosis of neonatal cholestasis. Moreover, stricter diagnostic criteria for bile duct loss (more than 2/3 of bile ducts) should be applied for the definitive diagnosis of intrahepatic bile duct paucity, because bile duct loss also frequently occurs in infants suffering with neonatal hepatitis.
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Alternate Webpage(s)	http://koreanjpathol.org/upload/journal/2008_0043.pdf
Language	English
Access Restriction	Open
Subject Keyword	Bile Duct Diseases Bile duct carcinoma Bile duct structure Bile fluid Biliary Atresia Chemical and Drug Induced Liver Injury Cholestasis Common Bile Duct Calculi Differential Diagnosis Duct (organ) structure Fibrosis Gamma-glutamyl transferase Giant cell hepatitis Histopathology Impatent structure Interferon Type II Intrahepatic bile duct KRT17 wt Allele Liver diseases Patients Portal System Specimen diagnostic criteria
Content Type	Text
Resource Type	Article