Related Experiment Video

Updated: Oct 11, 2025

Extrahepatic Bile Duct and Gall Bladder Dissection in Nine-Day-Old Mouse Neonates
06:10

Extrahepatic Bile Duct and Gall Bladder Dissection in Nine-Day-Old Mouse Neonates

Published on: August 23, 2022

2.1K

Hemolysis in Early Infancy: Still a Cause of Cholestatic Neonatal Giant Cell Hepatitis

Hao Wu1, Oya Tugal2, Antonio R Perez-Atayde3

  • 1Department of Pathology, Yale New Haven Hospital and Yale School of Medicine, New Haven, CT.

The American Journal of Surgical Pathology
|December 2, 2021
PubMed

Insights

Neonatal cholestasis can be caused by giant cell hepatitis linked to hemolytic disease of the newborn. Early diagnosis is aided by elevated aspartate aminotransferase over alanine aminotransferase levels in infants with ABO or Rh incompatibility.

Area of Science:

  • Neonatology
  • Pediatric Gastroenterology
  • Hematology

Background:

  • Hemolytic anemia of the newborn was a primary cause of hyperbilirubinemia before anti-D antibody prophylaxis.
  • Current differential diagnoses for neonatal cholestasis include hepatobiliary abnormalities, infections, and metabolic disorders.

Purpose of the Study:

  • To highlight the importance of considering cholestatic giant cell hepatitis in neonatal cholestasis, particularly in infants with hemolysis.
  • To present cases of neonatal cholestasis associated with Coombs' positive hemolysis due to ABO and/or Rh incompatibility.

Main Methods:

  • Case series reporting on three infants with neonatal cholestasis.
  • Clinical and laboratory data analysis, including Coombs' test results and liver enzyme levels.

Main Results:

  • Three infants presented with cholestatic giant cell hepatitis and Coombs' positive hemolysis.
  • Causes included ABO incompatibility (1), Rh incompatibility (1), and combined ABO and Rh incompatibility (1).
  • A notable elevation of aspartate aminotransferase over alanine aminotransferase was observed.

Conclusions:

  • Cholestatic neonatal giant cell hepatitis associated with hemolysis, though rare, remains a consideration in neonatal cholestasis.
  • Elevated aspartate aminotransferase relative to alanine aminotransferase may serve as an early diagnostic indicator.

More Related Videos

Isolation of Neonatal Extrahepatic Cholangiocytes07:54

Isolation of Neonatal Extrahepatic Cholangiocytes

Published on: June 5, 2014

10.4K
A Neonatal BALB/c Mouse Model of Necrotizing Enterocolitis05:39

A Neonatal BALB/c Mouse Model of Necrotizing Enterocolitis

Published on: November 30, 2021

3.8K

Related Concept Videos

Lifecycle of Erythrocytes01:22

Lifecycle of Erythrocytes

Erythrocytes, also known as red blood cells, constantly move through blood capillaries. As a result, they damage their plasma membrane due to the continuous friction. Typically, after 100 to 120 days, erythrocytes become rigid and fragile as they wear out. As they pass through small vessels in the spleen and liver, they can get trapped and break apart into fragments.
The resident phagocytic macrophages deal with these damaged cells by engulfing them and separating their globin and heme groups....
2.6K
Development of Immunocompetence01:22

Development of Immunocompetence

The initiation of cell-mediated immunity can be observed as early as the third month of fetal growth, with active antibody-mediated immunity following approximately one month later.
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
503
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
27
Diseases of the Liver and Gallbladder01:26

Diseases of the Liver and Gallbladder

Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
1.4K
Transcytosis of IgG01:15

Transcytosis of IgG

Transcytosis is the process in which molecules are internalized by endocytosis, transported across the cell, and released through exocytosis from the opposite end of the cell. Molecules such as insulin, immunoglobulins, and certain nutrients are transferred through the recycling endosomes by recycling and transcytosis.
IgG molecules from a mother undergo transcytosis starting around 13 weeks of gestation. The amount of IgG transferred and entering the fetal blood circulation increases with...
3.0K
Inborn Errors of Metabolism01:20

Inborn Errors of Metabolism

Phenylketonuria (PKU) is a protein metabolism disorder characterized by high blood levels of the amino acid phenylalanine. This results from a mutation in the gene responsible for phenylalanine hydroxylase, an enzyme that converts phenylalanine into tyrosine. When this enzyme is deficient, phenylalanine builds up in the blood, leading to symptoms such as vomiting, rashes, seizures, growth deficiency, and severe mental retardation. An early diagnosis and a diet restricting phenylalanine intake...
301