What are the histologic features of intrahepatic neonatal cholestasis?

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 IHNC of 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

Reference: Bellomo-Brandao MA, Escanhoela CAF, Meirelles LR, Porta G, Hessel G. Analysis of the histologic features in the differential diagnosis of intrahepatic neonatal cholestasis. World J Gastroenterol 2009; 15(4): 478-483 http://www.wjgnet.com/1007-9327/15/478.asp

Correspondence to: Maria Angela Bellomo-Brandao, Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Rua Aristides Lobo, 789. Campinas, São Paulo 13083-060, Brazil. bellomobrandao@globo.com

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H. pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

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