Evaluation of cholestasis in Iranian infants less than three months of age

Abstract

Aim: The aim of this study is to find-out the possible etiologies in Iranian infants less than three months in Shiraz, South of Iran.

Background: Cholestatic jaundice most probably occurs due to a pathological condition and the most frequent causes in early infancy are neonatal hepatitis and biliary atresia. Early diagnosis and treatment of infantile cholestasis can improve prognosis of liver diseases by prevention of the complications of these disorders.

Patients and methods: In this retrospective study, 122 infants under 3 months of age with cholestasis were studied in Nemazee Hospital (affiliated to Shiraz University of Medical Sciences) during the years 2001-2011. Demographic data, duration of jaundice, liver biopsy and the causes of cholestasis were recorded.

Results: There were 76 males (62.3%) and 46 females (37.7%) with a mean age of 54.4 ± 23.7 days. The most common clinical finding was jaundice that was seen in all patients (100%).The onset of jaundice was the first day to the fifty two days of age, with an average age of 15.6 ± 16.1 days. Other findings included hepatomegaly in 92 patients (76.4%), clay-color stool in 54 (44.3%), and splenomegaly in 29 patients (23.8%). In this study, the most common causes of cholestasis were biliary atresia (30=24.6%), idiopathic neonatal hepatitis (30= 24.6%) and bile ducts paucity (16=10.3).

Conclusion: The results of this study showed that biliary atresia and neonatal hepatitis are the most common causes of infantile cholestasis in this area. It is recommended that biliary atresia should be discriminated from other forms of neonatal cholestasis.

Keywords: Biliary atresia; Cholestasis; Neonatal jaundice.