Etiology of 142 cases of infant cholestasis and the evaluation of the common diagnostic methods / 中国实用儿科杂志

ABSTRACT

OBJECTIVE: To investigate the etiology of infant cholestasis,and to evaluate the commonly clinical diagnostic methods in diagnosing infant biliary atresia(BA). METHODS: A total of 142 hospitalized children with infant cholestasis in the pediatric ward of our hospital from January 1,2012 to November 30,2016 were included. RESULTS: Totally 99 cases(69.7%)were comfirmed,and the most common causes were BA,cytomegalovirus infection and citrin protein deficiency.Totally 37 cases(26.1%)were diagnosed as idiopathic infant hepatitis and 6 cases(4.2%)were undiagnosed. Compared with no-BA group,acholie stools predominated in BA group,and the serum γ-GT in BA were significantly higher. Abdominal ultrasonography showed that 81.2% were cholecyst undiscovered or small in size in BA. Hepatobiliary scintigraphy(HBS)showed that 95.0% had no image of gallbladder or radioactive concentration in bowel and 5.0% had delayed image or radioactive conceatration in BA. The difference between the two group;was statistical(P<0.01). The sensitivity,specificity,and accuracy of acholic stools to diagnose BAwere 91.3%,92.9%,and 92.2%,γ-GT≥300 U/Lwere 65.2%,91.8%,83.3%,abdominal ultrasonography were 68.8%,90.8%,84.9%,HBS were 95%,50%,68.0%,respectively. CONCLUSION: The common causes of infant cholestasis in BA,idiopathic hepatitis,cytomegalovirus infection,and Citrin protein deficiency. In the infant cholestasis with acholic stools,infracostal liver≥3 cm,serum γ-GT≥300 U/L,cholecyst undiscovered or small in size in abdominal ultrasonography,HBS undiscovered or delayed image of gallbladder or radioactive concentration in bowel,the BA should be suspected.