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Evaluation of cholestatic jaundice in young infants.

In developing countries cholestatic jaundice occurs in young infants due to a variety of causes. Irrespective of the etiology the disease’s consequences on liver cell function are the same. Hence early recognition and treatment may prevent permanent liver damage at least in some of the patients. This study was conducted to analyze the various causes that lead to cholestatic jaundice in infants in a developing country specifically India. A complete blood picture total liver function test gamma glutamyl transpeptidase lipid profile ultrasound abdomen TORCH screening and percutaneous liver biopsy were done among 36 infants (20 males and 16 females) below 6 months of age with cholestatic jaundice. Overall cholestasis in young infants has a varied etiology including congenital infections malformations metabolic disorders and inherited functional disorders of unknown etiology. Delayed presentation was the single most important factor which resulted in the poor prognosis of cholestatic syndrome of infancy in developing countries. It is noted that 10 (neonatal hepatitis 4 idiopathic 4 hypothyroidism 1 and Bylers disease 1) out of a total of 36 had a normal liver function a minimum of 1 year after cholestasis. It is also noted that percutaneous liver biopsy is safe in young infants and is most useful for diagnosis.