Cholestatic neonatal jaundice can be the initial manifestation of a very heterogeneous group of illnesses of different etiologies; many of them are potentially serious condition that indicates hepatobiliary dysfunction. The rapid detection of cholestatic neonatal jaundice and timely and accurate diagnosis is challenging because of the gravity of this consequences, successful treatment and prognosis. However, there are no data available in the literature pertaining to the histologic features present in neonatal hepatitis to aid in the differential diagnosis of IHNC.
A research article to be published on January 28, 2009 in the World Journal of Gastroenterology has recently addressed this question. The research team led by Dr Maria Angela Bellomo-Brandao from Brazil compared the histologic features of the liver in intrahepatic neonatal cholestasis (IHNC) with infectious, genetic-endocrine-metabolic, and idiopathic etiologies.
In their study, Liver biopsies from 86 infants with IHNC were evaluated. The inclusion criteria consisted of jaundice beginning at 3 mo of age and a hepatic biopsy during the 1st year of life. Cholestasis, eosinophilia, giant cells, erythropoiesis, siderosis, portal fibrosis, and the presence of a septum were evaluated.
They found that there were no significant differences among different etiologies of IHNC in relation to the following histologic features: cholestasis, eosinophilia, giant cells, portal fibrosis, the presence or absence of a septum, and siderosis. A significant difference was observed in IHNCof infectious etiology, which presented with more severe erythropoiesis than the genetic-endocrine-metabolic and idiopathic etiologies. This is the first study to analyze standardized histologic features usually present in IHNC