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Analysis of the histologic features in the differential diagnosis of intrahepatic neonatal cholestasis
Authors:Maria Angela Bellomo-Brandao  Cecilia AF Escanhoela  Luciana R Meirelles  Gilda Porta  Gabriel Hessel
Abstract:AIM: To compare the histologic features of the liver in intrahepatic neonatal cholestasis (IHNC) with infectious,genetic-endocrine-metabolic, and idiopathic etiologies.METHODS: Liver biopsies from 86 infants with IHNC were evaluated. The inclusion criteria consisted of jaundice beginning at 3 mo of age and a hepatic biopsy during the 1st year of life. The following histologic features were evaluated: cholestasis, eosinophilia, giant cells, erythropoiesis, siderosis, portal fibrosis, and the presence of a septum.RESULTS: Based on the diagnosis, patients were classified into three groups: group 1 (infectious; n = 18),group 2 (genetic-endocrine-metabolic; n = 18), and group 3 (idiopathic; n = 50). There were no significant differences with respect to the following variables:cholestasis, eosinophilia, giant cells, siderosis, portal fibrosis, and presence of a septum. A significant difference was observed with respect to erythropoiesis,which was more severe in group 1 (Fisher's exact test,P = 0.016).CONCLUSION: A significant difference was observed in IHNC of infectious etiology, in which erythropoiesis was more severe than that in genetic-endocrine-metabolic and idiopathic etiologies, whereas there were no significant differences among cholestasis, eosinophilia,giant cells, siderosis, portal fibrosis, and the presence of a septum.
Keywords:Intrahepatic cholestasis  Liver histopathology  Neonatal jaundice  Neonatal liver disease
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