Etiology and Clinical presentation of cholestatic jaundice during infancy period in Thammasat University Hospital

Abstract

Background: The diagnosis of cholestasis during infancy is challenging because of its diverse etiology.

Objective: To determine the etiology and clinical profile of cholestatic jaundice during infancy in Thammasat University hospital.

Methods: The medical records of all patients with the diagnosis of cholestatic jaundice between January 2012 and January 2017 were reviewed retrospectively. Demographic characteristic, investigation, and etiology of cholestasis were collected.

Results: We enrolled 122 infants in our study (74 boys). The mean age at presentation of jaundice was 46.6 ± 62.6 days. Preterm infants numbered 68 (55.7%). Parenteral nutritional-associated liver disease (PNALD) in infants was the most common cause of cholestatic jaundice (29.5%) and occurred more often in preterm infants (75.5%). Idiopathic neonatal hepatitis (17.2%) and septicemia (13.1%) were common. Sixteen infants (13.1%) had biliary tract abnormalities, biliary atresia (BA) in 14 (11.5%) and choledochal cyst (2%), respectively. In biliary atresia, the mean
age of jaundice by parental history was 47.1 days but the mean age at the first medical visit was 80.6 days.

Conclusions: PNALD in sepsis infants is the most common etiology of cholestatic jaundice in our setting, particularly in preterm infants. Identification of the possible disorders of cholestatic jaundice and accurate diagnosis are important for successful management and a better outcome.