The Clinical Features of Chronic Neonatal Hepatitis: Non-familial, Non-metabolic and Non-A, B, C Viral Hepatitis.
- Author:
Ji Ae PARK
1
;
Chang Hun LEE
;
Jae Hong PARK
Author Information
1. Department of Pediatrics, College of Medicine, Pusan National University, Busan, Korea. jhongpark@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Neonatal hepatitis;
Chronic;
Persistent alanine aminotrasferase elevation
- MeSH:
Alanine;
Bilirubin;
Busan;
Cholestasis;
Cytomegalovirus;
Fibrosis;
Hepatitis*;
Hepatomegaly;
Humans;
Immunoglobulin M;
Jaundice;
Liver;
Liver Diseases;
Male;
Necrosis;
Pediatrics;
Polymerase Chain Reaction
- From:Korean Journal of Pediatric Gastroenterology and Nutrition
2006;9(2):242-248
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Neonatal hepatitis is the major cause of neonatal cholestasis and may be divided into infectious, metabolic, genetic, and idiopathic neonatal hepatitis. Non-familial, non-metabolic, and non-A, B, C viral neonatal hepatitis is known to have made satisfactory progress, but little is known about its chronic clinical features. METHODS: Clinical and histological assessments were carried out in 34 cases with chronic neonatal hepatitis [elevated serum alanine aminotrasferase (ALT) level for more than 6 months] except for A, B, C viral hepatitis, metabolic, or genetic neonatal hepatitis, who were admitted to the Department of Pediatrics, Pusan National University Hospital, from January 1998 to January 2004. RESULTS: Males were more common (70%). Jaundice (100%) and hepatomegaly (44%) were frequent manifestations. Peak serum ALT levels were most commonly below 300 IU/L in 41.2% of patients and peak serum direct bilirubin levels were most commonly between 1.0~5.0 mg/dL in 50% of patients. Ten cases (34%) of 29 patients had positive serum cytomegalovirus (CMV) IgM or urine CMV polymerase chain reaction. Serum ALT level was normalized within 1 year in 11 (37.9%) of 29 cases, and within 2 years in 9 (69.2%) of 13 cases. Serum ALT level was elevated persistently over 2 years in four (30.7%) of 13 cases. Histologic findings such as portal or periportal activity, lobular necrosis, portal or periportal fibrosis were more severe in patients with persistent ALT elevation over 2 years than in those showing normalization of ALT within 2 years (p>0.05). CONCLUSION: When the elevation of ALT level sustains over 1 year in non-familiar, non-metabolic, non-A, B, C viral neonatal hepatitis, an assessment of the severity of liver injury and a careful monitoring about chronic liver disease may be required.
