Giant Cell Hepatitis in Copper Toxicosis

Area of Science:

• Pediatrics
• Hepatology
• Toxicology

Background:

• Cholestatic jaundice in infants is primarily caused by biliary obstruction or hepatocellular dysfunction, with biliary atresia and neonatal hepatitis being common etiologies.
• While cholestasis from toxins is rare in infants, conditions like Indian childhood cirrhosis (ICC) exist.
• Exogenous copper exposure is an uncommon but potential cause of infantile liver disease.

Purpose of the Study:

• To report a rare case of infantile cholestasis due to copper hepatotoxicosis.
• To identify the source of exogenous copper exposure in an infant.
• To demonstrate the clinical improvement following removal of the copper source.

Main Methods:

• A 4-month-old infant presented with cholestasis.
• Diagnostic workup included liver biopsy for histopathological examination.
• Detailed history was taken to identify potential sources of toxin exposure.

Main Results:

• Liver biopsy confirmed copper-related hepatotoxicosis.
• The source of exogenous copper was identified as copper tumblers used for formula preparation.
• The infant showed significant clinical improvement after discontinuing the use of copper tumblers.

Conclusions:

• Copper hepatotoxicosis is a rare but treatable cause of infantile cholestasis.
• Environmental and dietary sources of copper should be considered in cases of unexplained infantile cholestasis.
• Early identification and removal of the exogenous copper source are crucial for successful management.