The Clinicopathological Parameters for Making the Differential Diagnosis of Neonatal Cholestasis
Korean Journal of Pathology
;
: 43-47, 2009.
Artigo
em Inglês
| WPRIM
| ID: wpr-157896
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.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Estresse Psicológico
/
Transferases
/
Bile
/
Ductos Biliares
/
Ductos Biliares Intra-Hepáticos
/
Biópsia
/
Atresia Biliar
/
Fibrose
/
Colestase
/
Diagnóstico Diferencial
Tipo de estudo:
Estudo diagnóstico
Limite:
Humanos
/
Lactente
/
Masculino
/
Recém-Nascido
Idioma:
Inglês
Revista:
Korean Journal of Pathology
Ano de publicação:
2009
Tipo de documento:
Artigo
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