scholarly journals DIFFERENTIATING BILIARY ATRESIA FROM OTHER CAUSES OF CHOLESTASIS JAUNDICE IN INFANTS

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Kim Oanh Bui
Keyword(s):  
Biliary Atresia ◽  
Cytomegalovirus Infection ◽  
Demographic Data ◽  
Signs And Symptoms ◽  
Neonatal Hepatitis ◽  
Bile Formation ◽  
Common Causes ◽  
Laboratory Investigations ◽  
Infantile Cholestasis ◽  
Idiopathic Neonatal Hepatitis

Aim: The aim of this study is to find out the cholestatic etiologies in infants and differences of clinical features, laboratory investigations between biliary atresia and other causes of cholestasis at Vietnam Children Hospital. Background: Cholestasis is defined as reduced bile formation or biliary flow. It results of varied causes. Early detection of biliary atresia is to intervene in time and have the best outcome. Patient and methods: In this retrospective study, 305 infants under 12 months of age with cholestasis were studied in Vietnam Children Hospital during 1/2017-7/2018. Demographic data, duration of jaundice, signs and symptoms as well as laboratory, imaging, liver biopsy and the causes of cholestasis were recorded, divided into 2 group BA and Non-BA. Results: 305 infants (194 boys, 111 girls) with cholestasis and mean age of 83,22±72,10 days were included in the study. The most common causes of cholestasis were idiopathic neonatal hepatitis (33,8%), biliary atresia (25,9%), cytomegalovirus infection (21,6%). In BA group, pale stool (100%), Hepatomegaly (98,7%);  increasing less AST, ALT, more GGT level than Non-BA. Find out GGT cutoff > 212,05 UI/l in diagnosing BA. Conclusion: Biliary atresia and idiopathic neonatal hepatitis are the most common causes of infantile cholestasis. Pale stool, hepatomegaly and GGT elevation > 212,05 UI/l are the most reliable tests for diagnosing BA.  

The role of CK7, Ki-67, CD34 and vimentin in the differentiation between biliary atresia and idiopathic neonatal hepatitis in Egyptian cholestatic neonates

Apmis ◽  
2012 ◽  
Vol 120 (7) ◽  
pp. 529-538 ◽  
Author(s):  
HAYAM ABDEL SAMIE AIAD ◽  
MONA ABDEL HALIM KANDIL ◽  
REHAB MONIR SAMAKA ◽  
MERVAT MAHMOUD SULTAN ◽  
MOHAMED TAWFIK BADR ◽  
...  
Keyword(s):  
Biliary Atresia ◽  
Neonatal Hepatitis ◽  
Ki 67 ◽  
Idiopathic Neonatal Hepatitis

Idiopathic Neonatal Hepatitis in One DNA Fingerprint Identical Twin

PEDIATRICS ◽  
1992 ◽  
Vol 89 (2) ◽  
pp. 329-330
Author(s):  
PIETRO VAJRO ◽  
ANGIOLA FONTANELLA ◽  
EMILIA VUTTARIELLO ◽  
ANNA DE VINCENZO ◽  
GIULIANA FORTUNATO
Keyword(s):  
Biliary Atresia ◽  
Hepatobiliary Disease ◽  
Identical Twin ◽  
Dna Fingerprint ◽  
Neonatal Hepatitis ◽  
Neonatal Cholestasis ◽  
Injury Site ◽  
Extrahepatic Biliary Atresia ◽  
Dizygotic Twins ◽  
Idiopathic Neonatal Hepatitis

For the practicing pediatrician, the most commonly encountered causes of neonatal cholestasis are idiopathic neonatal hepatitis (INH) and extrahepatic biliary atresia (EHBA). However, despite extensive research, little improvement in our understanding of the etiology of INH and EHBA has occurred.1 It has been proposed that both of them may be part of a continuum of hepatobiliary disease caused by a common insult with a different predominant injury site.2 In this respect, it is interesting that, up to the present, several cases of discordance for EHBA in twins of various zygosity have been reported,3-8 whereas no data are available about either concordance or discordance for INH both in monozygotic and dizygotic twins.

scholarly journals Evaluation of Secondary Chronic Suppurative Osteomyelitis of Jaw in 15 Cases: A Retrospective Analysis

2021 ◽  
Author(s):  
Varsha Manekar ◽  
Vandana Gadve ◽  
Vijaya Dhote ◽  
Sulabha Radke
Keyword(s):  
Antibiotic Therapy ◽  
Chronic Osteomyelitis ◽  
Imaging Techniques ◽  
Demographic Data ◽  
Correct Diagnosis ◽  
Maxillofacial Surgery ◽  
Signs And Symptoms ◽  
Oral And Maxillofacial Surgery ◽  
Odontogenic Infections ◽  
Common Causes

Introduction: Chronic osteomyelitis may become a refractory condition and is more difficult to treat. Therefore, for correct diagnosis and evaluation of chronic osteomylitis, primary health care practitioners must have knowledge of signs and symptoms associated with osteomyelitis for effective management. Aim: To evaluate secondary chronic suppurative osteomyelitis of jaw in 15 cases. Materials and Methods: This was a retrospective study of all patients treated for maxillo-mandibular secondary chronic osteomyelitis over a period of six years (January 2013 to December 2018) in Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Nagpur, Maharashtra, India. This study was carried out in between November 2019 to November 2020. A total of fifteen cases were identified which were diagnosed as Secondary Chronic Suppurative Osteomyelitis (SCO) and treated for same. The cases were evaluated for demographic data, risk factors, aetiology, clinical presentation, radiological findings and the management. Data was collected through retrospective search of records and was arranged in descriptive tabular format without statistical analysis. Results: Out of 15 cases 9 (60%) were female. The patients ranged in age from 21 to 56 years with a mean age of 36.6±9.0 years. The mean age at first symptoms was 35.5 years (20-55), with a standard deviation of 9.12 years. The distribution of osteomyelitis in the jaws was dominated by the cases that occurred in the mandible i.e., 73.33% (11 cases) and the maxilla 26.66% (four cases) with most common involved site was body and angle region of mandible (eight cases) followed by premolar region two cases and anterior region one case. In this study, five cases (33.33%) had carious lesion and seven cases (46.67%) had infected extraction socket. Other causes of infection were osteoradionecrosis in one case and superimposed infection like mucormycosis in two cases. The most common causes of chronic osteomyelitis of the jaws were directly related to odontogenic infections like infected unhealed socket. Decortication and curettage was done in four cases. Decortication and sequestrectomy were performed in five cases and debridement of necrosed bone in three cases. Sinus opening, debridement of necrosed wall and packing were done in three cases of SCO involving maxilla. Duration of antibiotic therapy in all patients averaged five weeks. Conclusion: The accurate diagnosis with the help of recent imaging techniques, adequate antibiotic therapy as well as surgical treatment was keys for the success of SCO management.

Comparison of different diagnostic methods for differentiating biliary atresia from idiopathic neonatal hepatitis

2009 ◽  
Vol 33 (6) ◽  
pp. 439-446 ◽  
Author(s):  
Ji-Gang Yang ◽  
Da-Qing Ma ◽  
Yun Peng ◽  
Lei Song ◽  
Chun-Lin Li
Keyword(s):  
Biliary Atresia ◽  
Diagnostic Methods ◽  
Neonatal Hepatitis ◽  
Idiopathic Neonatal Hepatitis

scholarly journals Usefulness of clinical and laboratory parameters for differentiation of biliary atresia from idiopathic neonatal hepatitis: Experience in a tertiary care hospital of Bangladesh

2015 ◽  
Vol 4 (1) ◽  
pp. 30-36
Author(s):  
Kaniz Sultana ◽  
Ariful Haque ◽  
Nadira Musabbir ◽  
Syeda Afria Anwar ◽  
Faika Hussain ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Biliary Atresia ◽  
Tertiary Care ◽  
Neonatal Hepatitis ◽  
Care Hospital ◽  
Neonatal Cholestasis ◽  
Cross Sectional ◽  
Laboratory Parameters ◽  
Upper Limit ◽  
Idiopathic Neonatal Hepatitis

Background: The two most common and important causes of neonatal cholestasis (NC) are biliary atresia (BA) and Idiopathic neonatal hepatitis (INH). There is no single test that can definitely differentiate these two entities. Objective: To evaluate the diagnostic accuracy of clinical and laboratory parameters for diagnosis of biliary atresia. Methods: This cross-sectional study was conducted at the department of Pediatric Gastroenterology and Nutrition of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from August 2013 through July 2015 among purposively sampled infants with neonatal cholestasis. Results: Total 86 neonatal cholestatic cases were studied. Term baby and good birth weight are significantly higher in BA cases. The presence of persistent pale colored stool is significantly more in patients with BA (p 0.000). GGT is the only liver enzyme that was found to be useful differentiating BA from INH at a cut-off value ≥ 524U/L or 9.5 times higher than upper limit normal with sensitivity and specificity of 81.6% and 72.9% respectively. In the present study the diagnostic accuracy of persistent pale colored stool found to be highest (79.1 %). Conclusion: The present study showed that Persistent pale colored stool and serum level of GGT with a cut-off value ≥524 U/L or 9.5 times higher than upper limit normal can be considered as predictive markers for differentiation of Biliary atresia from Idiopathic neonatal hepatitis. CBMJ 2015 January: Vol. 04 No. 01 P: 30-36

Differentiating Biliary Atresia From Idiopathic Neonatal Hepatitis: A Novel Keratin 7 Based Mathematical Approach on Liver Biopsies

2021 ◽  
pp. 109352662098373
Author(s):  
Sunayana Misra ◽  
Kaushik Majumdar ◽  
Puja Sakhuja ◽  
Priyanka Jain ◽  
Lavleen Singh ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Biliary Atresia ◽  
Roc Curve ◽  
Cell Activation ◽  
Neonatal Hepatitis ◽  
Mathematical Approach ◽  
Diagnostic Challenge ◽  
Significant Difference ◽  
Keratin 7 ◽  
Idiopathic Neonatal Hepatitis

Background and Aims Differentiating biliary atresia (BA) from idiopathic neonatal hepatitis (INH) is vital in routine pediatric practice. However, on liver biopsy, few cases offer a diagnostic challenge to discriminate these entities with certainty. Bile ductular reaction (DR), intermediate hepatobiliary cells (IHBC) and extra-portal ductules (EPD) indicate progenitor cell activation, as a response to various hepatic insults. The present study aims to quantify DR, IHBC and EPD by Keratin 7 (CK7) immunohistochemistry (IHC) in BA and INH and to devise a mathematical approach to better differentiate the two, especially in histologically equivocal cases. Methods A total of 98 cases were categorized on biopsy as BA, INH or equivocal histology, favoring BA or INH. CK7 DR mean, IHBC mean and EPD mean values were compared between BA and INH. A formula was derived to help distinguish these two entities, the cut-off value, sensitivity and specificity of which were determined by receiver operating characteristic (ROC) curve. This formula was applied and validated on histologically equivocal cases. Results Univariate logistic regression revealed significant difference between BA and INH with respect to CK7 DR and CK7 EPD mean (p < 0.001 in both); however, CK7 IHBC mean was not significant (p = 0.08). On multivariate logistic regression, only CK7 DR had significant impact on diagnosis (p < 0.001). A formula: (CK7 DR) 2  + (CK7 EPD)/(CK7 IHBC) was derived to help distinguish BA from INH. Cut off value of 10.5 and above, determined by ROC curve, favored a diagnosis of BA (sensitivity= 93.4%, specificity= 94.6%). Histologically equivocal and discrepant cases could be correctly categorized using this formula. Conclusions Formula using CK7 IHC parameters may aid pathologists better distinguish BA from INH, especially in histologically equivocal cases.

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