Clinical features differentiating biliary atresia from other causes of neonatal cholestasis
Annals of the Academy of Medicine, Singapore
; : 648-654, 2010.
Article
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| WPRIM
| ID: wpr-234078
Responsible library:
WPRO
ABSTRACT
<p><b>INTRODUCTION</b>This study determined any clinical features which may help to differentiate biliary atresia (BA) from other causes of neonatal cholestasis (NC).</p><p><b>MATERIALS AND METHODS</b>A prospective and observational study was conducted on consecutive infants with NC referred to the University of Malaya Medical Centre, Malaysia, between November 1996 and May 2004.</p><p><b>RESULTS</b>The 3 most common causes of cholestasis among the 146 infants with NC studied were idiopathic neonatal hepatitis (n = 63, 43%), BA (n = 35, 24%) and congenital cytomegalovirus hepatitis (n = 13, 9%). Common clinical features at presentation were jaundice (100%), hepatomegaly (95%), splenomegaly (52%) and pale stools (47%). Three clinical features noted to be sensitive for BA were the presence of acholic or variably acholic stools on admission, a liver which was firm/hard in consistency and a palpable liver of ≥4 cm (sensitivity of 77%, 80% and 94%, respectively), but the corresponding specificity was poor (51%, 65% and 39%, respectively). The stools of 2 children with BA were pigmented initially but became acholic subsequently.</p><p><b>CONCLUSIONS</b>We did not find any single clinical feature with sufficient sensitivity and specificity to differentiate BA from other causes of NC. Repeated inspection of stools colour is necessary as occasionally, patients with BA may have initial pigmented stools. Biochemical assessment and imaging studies are important in the assessment of any infant with NC.</p>
全文:
1
索引:
WPRIM
主要主题:
Biliary Atresia
/
Logistic Models
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Cholestasis
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Prospective Studies
/
Cytomegalovirus Infections
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Cytomegalovirus
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Diagnosis
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Diagnosis, Differential
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Hepatitis
/
Hepatomegaly
研究类型:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
限制:
Adult
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Female
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Humans
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Male
/
Newborn
国家/地区名称主题:
Asia
语言:
En
期刊:
Annals of the Academy of Medicine, Singapore
年:
2010
类型:
Article