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Published on: August 19, 2020
[Prolonged icterus as a difficult diagnostic problem in small children--own observations]
Barbara Kramer1, Elzbieta Dółka, Jadwiga Michalecka
1II Klinika Pediatrii i Alergologii, Instytut Centrum Zdrowia Matki Polki, ul. Rzgowska 281/289, 93-338 Łódź, Poland.
Insights
Prolonged infant jaundice is often caused by infections or metabolic diseases. Prompt diagnosis is crucial for effective treatment and preventing liver failure in children.
Area of Science:
- Pediatrics
- Neonatology
- Hepatology
Context:
- Prolonged icterus (jaundice) in infants presents a diagnostic challenge.
- Understanding the etiology of prolonged jaundice is critical for timely intervention.
- This study retrospectively analyzes causes of prolonged icterus in children.
Purpose:
- To evaluate the causes of prolonged icterus in pediatric patients over 16 years.
- To identify common etiologies of unconjugated hyperbilirubinemia and cholestasis in infants.
- To analyze the outcomes of different causes of prolonged jaundice.
Summary:
- Respiratory tract infections and cytomegalovirus infections were the most frequent causes of prolonged icterus in groups I and IIa.
- Metabolic diseases (galactosemia, fructosemia, mucoviscidosis) and genetic syndromes (Crigler-Najjar, Allagille, Byler disease) were also identified.
- Extrahepatic biliary atresia in group IIb required surgical intervention (Kasai operation).
Impact:
- Highlights the importance of thorough investigations for diagnosing the cause of prolonged infant jaundice.
- Emphasizes that early diagnosis improves treatment outcomes and prevents potential hepatic failure.
- Provides insights into the spectrum of causes for prolonged icterus in a pediatric population.
Unlabelled:
THE AIM of the study was the retrospective evaluation of causes of prolonged icterus in children treated in the Second Department of Peadiatrics and Allergology in Łódź during the last 16 years.
Material And Methods:
361 children aged 3 weeks to 15 months of 12650 patients hospitalised in our Clinic were analysed. All the examined children were divided into two groups group I consisted of 314 children with unconjugated hyperbilirubinemia and group II of 47 patients with cholestasis Additionally the cholestatic group was divided into two subgroups: IIa consisted of 41 children with intrahepatic cholestasis and IIb--six children with extrahepatic cholestasis.
Results:
The most common reasons of icterus in groups I and IIa were respiratory tract infections and cytomegalovirus infections All of these children recovered. Metabolic diseases were diagnosed in 4 children (galactosemia, fructosemia and in two children mucoviscidosis) in 5 children other genetic syndromes (Crigler-Najjar, Allagille and in three Byler disease). Six children from group IIb with extrahepatic biliary atresia were transferred to the Department of Paediatric Surgery. All of them underwent Kasai operation.
Conclusions:
Small children's prolonged icterus needs immediate and intense investigations to set as fast as possible the correct diagnosis of its cause. Early diagnosis of its cause increases the prospect of effective treatment and prevents the child from potential development of hepatic failure.
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