Clinical Characteristics, Biochemical Profile and Etiology of Cholestatic Jaundice in Bangladeshi Infants: A Tertiary Care Hospital Experience

Abstract

Background: Biliary atresia (BA) and idiopathic neonatal hepatitis(INH) are the two most common aetiologies of neonatal cholestatic jaundice. Aims: This study has been carried out to find out clinical characteristics, biochemical profile, aetiologies of neonatal cholestasis . Methods: This cross-sectional study was done from March, 2013 through March, 2014 among 60 infants who presented with cholestatic jaundice at the department of Paediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh. Clinical history, physical examination findings were recorded and investigations were done as appropriate. Results: Studied subjects [male n=38 (63.3%), female n=22 (36.7%)] had their mean age at admission 99.5±48.2 days, mean age at onset of jaundice 9.18±8.42 days,hepatomegaly (100% cases), splenomegaly (40% cases), direct S. bilirubin 8.75±2.62 mg/dl, ALT 150.16±99.85 U/L and hemoglobin 9.08±1.72 gm/dl. Scintigraphy was found positive in 22 (36.7%). Histopathology findings of 54.5% liver biopsies were consistent with biliary atresia. Mean of total, direct and indirect serum bilirubin and ALT were significantly different between subjects with BA and idiopathic neonatal hepatitis (INH). Mean of serum direct bilirubin and serum ALT was more in subjects of INH (p 0.03 & p 0.003). Conclusion: Biliary atresia was found to be the most common cause of neonatal cholestasis among studied subjects. Most of the cases presented late and early referral of these cases is important for effective evaluation and judicious management.

J.Dhaka National Med. Coll. Hos. 2015; 21 (01): 37-41