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Clinical features differentiating biliary atresia from other causes of neonatal cholestasis
Annals of the Academy of Medicine, Singapore ; : 648-654, 2010.
Artículo en Inglés | WPRIM | ID: wpr-234078
ABSTRACT
<p><b>INTRODUCTION</b>This study determined any clinical features which may help to differentiate biliary atresia (BA) from other causes of neonatal cholestasis (NC).</p><p><b>MATERIALS AND METHODS</b>A prospective and observational study was conducted on consecutive infants with NC referred to the University of Malaya Medical Centre, Malaysia, between November 1996 and May 2004.</p><p><b>RESULTS</b>The 3 most common causes of cholestasis among the 146 infants with NC studied were idiopathic neonatal hepatitis (n = 63, 43%), BA (n = 35, 24%) and congenital cytomegalovirus hepatitis (n = 13, 9%). Common clinical features at presentation were jaundice (100%), hepatomegaly (95%), splenomegaly (52%) and pale stools (47%). Three clinical features noted to be sensitive for BA were the presence of acholic or variably acholic stools on admission, a liver which was firm/hard in consistency and a palpable liver of ≥4 cm (sensitivity of 77%, 80% and 94%, respectively), but the corresponding specificity was poor (51%, 65% and 39%, respectively). The stools of 2 children with BA were pigmented initially but became acholic subsequently.</p><p><b>CONCLUSIONS</b>We did not find any single clinical feature with sufficient sensitivity and specificity to differentiate BA from other causes of NC. Repeated inspection of stools colour is necessary as occasionally, patients with BA may have initial pigmented stools. Biochemical assessment and imaging studies are important in the assessment of any infant with NC.</p>
Asunto(s)
Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Atresia Biliar / Modelos Logísticos / Colestasis / Estudios Prospectivos / Infecciones por Citomegalovirus / Citomegalovirus / Diagnóstico / Diagnóstico Diferencial / Hepatitis / Hepatomegalia Tipo de estudio: Estudio diagnóstico / Estudio de etiología / Estudio observacional / Factores de riesgo Límite: Adulto / Femenino / Humanos / Masculino / Recién Nacido País/Región como asunto: Asia Idioma: Inglés Revista: Annals of the Academy of Medicine, Singapore Año: 2010 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Atresia Biliar / Modelos Logísticos / Colestasis / Estudios Prospectivos / Infecciones por Citomegalovirus / Citomegalovirus / Diagnóstico / Diagnóstico Diferencial / Hepatitis / Hepatomegalia Tipo de estudio: Estudio diagnóstico / Estudio de etiología / Estudio observacional / Factores de riesgo Límite: Adulto / Femenino / Humanos / Masculino / Recién Nacido País/Región como asunto: Asia Idioma: Inglés Revista: Annals of the Academy of Medicine, Singapore Año: 2010 Tipo del documento: Artículo