Clinical features differentiating biliary atresia from other causes of neonatal cholestasis
Annals of the Academy of Medicine, Singapore
; : 648-654, 2010.
Article
de En
| WPRIM
| ID: wpr-234078
Bibliothèque responsable:
WPRO
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>
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Atrésie des voies biliaires
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Modèles logistiques
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Cholestase
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Études prospectives
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Infections à cytomégalovirus
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Cytomegalovirus
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Diagnostic
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Diagnostic différentiel
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Hépatite
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Hépatomégalie
Type d'étude:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Risk_factors_studies
Limites du sujet:
Adult
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Female
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Humans
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Male
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Newborn
Pays comme sujet:
Asia
langue:
En
Texte intégral:
Annals of the Academy of Medicine, Singapore
Année:
2010
Type:
Article