Analysis of the histologic features in the differential diagnosis of intrahepatic neonatal cholestasis

• Published in: World journal of gastroenterology : WJG Vol. 15; no. 4; pp. 478 - 483
• Main Authors: Bellomo-Brandao, Maria Angela, Escanhoela, Cecilia A F, Meirelles, Luciana R, Porta, Gilda, Hessel, Gabriel
• Format: Journal Article
• Language: English
• Published: United States Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP 13083-970, Brazil%Department of Pathology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP 13083-970, Brazil%Department of Pediatrics, Children's Institute of Medical School of the University of S(a)o Paulo (USP), S(a)o Paulo-SP 05403-000, Brazil 28.01.2009; The WJG Press and Baishideng
• Subjects: Biopsy; Brief; Cholestasis, Intrahepatic - diagnosis; Cholestasis, Intrahepatic - etiology; Cholestasis, Intrahepatic - pathology; Diagnosis, Differential; Eosinophilia - pathology; Erythropoiesis; Female; Humans; Infant; Infant, Newborn; Liver - pathology; Male; 胆囊疾病; 胆囊积液; Liver histopathology; Neonatal liver disease; Neonatal jaundice; Intrahepatic cholestasis
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.15.478

AIM： To compare the histologic features of the liver in intrahepatic neonatal cholestasis （IHNC） with infectious, genetic-endocrine-metabolic, and idiopathic etiologies. METHODS： Liver biopsies from 86 infants with IHNC were evaluated. The inclusion criteria consisted of jaundice beginning at 3 mo of age and a hepatic biop- sy during the 1st year of life. The following histologic features were evaluated： cholestasis, eosinophilia, giant cells, erythropoiesis, siderosis, portal fibrosis, and the presence of a septum. RESULTS： Based on the diagnosis, patients were classified into three groups： group 1 （infectious; n = 18）, group 2 （genetic-endocrine-metabolic; n = 18）, and group 3 （idiopathic; n = 50）. There were no significant differences with respect to the following variables： cholestasis, eosinophilia, giant cells, siderosis, portal fibrosis, and presence of a septum. A significant dif- ference was observed with respect to erythropoiesis, which was more severe in group 1 （Fisher＇s exact test, P = 0.016）. CONCLUSION： A significant difference was observed in IHNC of infectious etiology, in which erythropoiesis was more severe than that in genetic-endocrine-meta- bolic and idiopathic etiologies, whereas there were no significant differences among cholestasis, eosinophilia, giant cells, siderosis, portal fibrosis, and the presence of a septum.