1.A Comparative Study Between Cytomegalovirus Immunoglobulin M-Positive and CMV Immunoglobulin M-Negative Biliary Atresia in Infants Attending a Tertiary Care Hospital in Bangladesh
Sharmin AKTER ; A S M Bazlul KARIM ; Md Wahiduzzaman MAZUMDER ; Md RUKUNUZZAMAN ; Khan Lamia NAHID ; Bishnu Pada DEY ; Maimuna SAYEED ; A Z M Raihanur RAHMAN ; Kaniz FATHEMA ; Mukesh KHADGA
Pediatric Gastroenterology, Hepatology & Nutrition 2022;25(5):413-421
Purpose:
Perinatal cytomegalovirus (CMV) infection can lead to biliary atresia (BA) in different entities. This study aimed to compare the clinical, hematological, biochemical, and histological features of infants with BA based on their CMV immunoglobulin M (IgM) status at presentation.
Methods:
This cross-sectional descriptive study was carried out between January 2019 and June 2020 at the Department of Pediatric Gastroenterology and Nutrition at the Bangabandhu Sheikh Mujib Medical University (BSMMU) in Dhaka. Forty-three patients with BA were selected purposively and categorized into either the CMV IgM-positive or CMV IgM-negative BA group. Categorical variables were compared using Fisher’s exact test and chi-square tests, while the Student’s t-test and Mann–Whitney U-test were used to compare continuous variables. For all statistical tests, a p-value <0.05 was considered statistically significant.
Results:
Thirty-three (76.7%) of the cases were between 2 and 3 months of age on admission.The clinical, hematological, and biochemical parameters did not differ significantly between the CMV IgM-positive and CMV IgM-negative BA groups. Most (50.0%) of the CMV IgMpositive cases had fibrosis stage F2, while 43.5% of the CMV IgM-negative cases had fibrosis stage F3, with no significant difference between the groups (p=0.391).
Conclusion
Our data shows no significant distinction between CMV IgM-positive and CMV IgM-negative BA, suggesting that CMV does not contribute to BA pathogenesis.
2.Rhabdomyosarcoma of the common bile duct mimicking choledochal cyst: a rare cause of obstructive jaundice.
Hassan NAZMUL ; Islam RAFIQUL ; Fathema KANIZ ; Sayeed MAIMUNA ; Wahiduzzaman Mazumder MD ; Bazlul Karim ASM ; Pada Dey BISHNU
Chinese Journal of Contemporary Pediatrics 2020;22(12):1338-1343
Extrahepatic biliary tract tumors are rare and among them rhabdomyosarcoma is most common. Rhabdomyosarcoma is a soft tissue malignant musculoskeletal tumor and is a very rare malignancy of the common bile duct in children. It usually presents as obstructive jaundice and/or pruritus. If there is no local invasion to the adjacent tissues, the radiological appearance of the tumor lesion is like a choledochal cyst. So the diagnosis is usually made at surgery or by preoperative biopsy. It is important to diagnose early and differentiate it from choledochal cyst and start treatment as early as possible for long time survival of the patient. This case report presented a case of a 10-year-old boy with recurrent onset of obstructive jaundice and fever preoperatively who was diagnosed as choledochal cyst and postoperatively as embryonal rhabdomyosarcoma of the common bile duct. After surgical resection and postoperative chemotherapy, the child had a good prognosis. So it is crucial to know that this rare tumor can mimic congenital choledochal cyst and it should be considered in the differential diagnosis of obstructive jaundice in children.
Child
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Choledochal Cyst
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Common Bile Duct/pathology*
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Diagnosis, Differential
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Humans
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Jaundice, Obstructive/etiology*
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Male
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Rhabdomyosarcoma, Embryonal/diagnosis*