Etiologic assessment of neonatal cholestasis: a six year study in Children Medical Center, Tehran

Abstract

Background: Neonatal cholestasis is an important disease of the liver and biliary ducts in infancy. In neglected cases, the disease has irreversible complications. Idiopathic neonatal hepatitis, biliary atresia, TORCH infections and choledochal cyst are important causes of neonatal cholestasis. The aim of this study was to determine the causes of cholestasis among neonates admitted to the Children’s Medical Center of Tehran University. Methods: This is a descriptive, retrospective study including 109 patients diagnosed with obstructive icterus, from 1994 to 2001. With data collected from hospital records, the inclusion criteria consisted of cholestasis with a conjugated bilirubin of up to 2 mg/dl from at least two laboratory samples (20% of total bilirubin). The definitive diagnosis of cholestasis included the laboratory investigations, which were in the patients’ hospital records and documented by their physicians. Results: Our patients (63 males and 46 females) had a mean age of 40±6 days. The most common clinical findings were icterus, acholic stool and hepatosplenomegaly. The most common cause of cholestasis was idiopathic neonatal hepatitis followed by biliary atresia, which together caused 75% of all the cases in this study. Conclusions: In our general population, the most common causes of neonatal cholestasis are hepatitis and biliary atresia. In other investigations, the etiology of neonatal cholestasis was different than that of this study. Because the number of different disorders presenting with cholestasis may be greater during the neonatal stage than at any other time of life, early diagnosis and treatment is very important for improved prognosis.

Keywords

• obstructive icterus