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Neonatal Hepatitis

Neonatal Hepatitis Abstract The presence of jaundice at birth or its onset early in the neonatal period may present formidable diagnostic difficulties to the pediatrician and to the pathologist, especially if the jaundice is prolonged and of the regurgitant form. If erythroblastosis fetalis is excluded, the differential diagnosis in most instances lies between congenital atresia of the bile ducts and neonatal (giant cell) hepatitis. Both these conditions have been the subject of studies in the literature,1-15 and it is apparent that many clinical and biochemical similarities exist between the two conditions. As a result, exploratory laparotomy is commonly undertaken in such cases to assess the patency of the biliary tree, and wedges of tissue resected from the liver are supplied to the pathologist for histologic examination. Since congenital atresia of the bile ducts and neonatal hepatitis are rare in clinical and pathologic practice, the purpose of this communication is to review the References 1. Craig, J. M., and Landing, B. H.: Form of Hepatitis in Neonatal Period Simulating Biliary Atresia , A.M.A. Arch. Path. 54:321-333 ( (Oct.) ) 1952. 2. Dible, J. H.; Hunt, W. E.; Pugh, V. W.; Steingold, L., and Wood, J. H. F.: Foetal and Neonatal Hepatitis and Its Sequelae , J. Path. & Bact. 67:195-206 ( (Jan.) ) 1954.Crossref 3. Schwartz, M. U.; Gilman, R. A.; Schwartz, M., and Settle, J.: Neonatal Hepatitis: Report of a Case Simulating Obstructive Jaundice , J. A. M. A. 155:557-559 ( (June 5) ) 1954.Crossref 4. Harris, R. C.; Andersen, D. H., and Day, R. L.: Obstructive Jaundice in Infants with Normal Biliary Tree , Pediatrics 13:293-307 ( (April) ) 1954. 5. Gellis, S. S.; Craig, J. M., and Hsia, D. Y.-Y.: Prolonged Obstructive Jaundice in Infancy: IV. Neonatal Hepatitis , A. M. A. Am. J. Dis. Child. 88:285-293 ( (Sept.) ) 1954. 6. Kiaer, W.: Hepatitis Foetalis , Ugesk. laeger 118:865-868 ( (July 26) ) 1956. 7. Krainin, P., and Lapan, B.: Neonatal Hepatitis in Siblings: Report of 2 Cases with Giant Multinucleated Liver Cells and Fatal Termination , J.A.M.A. 160:937-940 ( (March 17) ) 1956.Crossref 8. Thomson, J.: On Congenital Obliteration of the Bile Ducts , Edinburgh M. J. 37:523-531 ( (Dec.) ) 1891 9. 604-616 (Jan.) 10. 724-735 (Feb.) 1892. 11. Holmes, J. B.: Congenital Obliteration of the Bile Ducts: Diagnosis and Suggestions for Treatment , Am. J. Dis. Child. 11:405-431 ( (June) ) 1916. 12. Ladd, W. E.: Congenital Atresia and Stenosis of the Bile Ducts , J.A.M.A. 91:1082-1085 ( (Oct. 13) ) 1928.Crossref 13. Sweet, L. K.: Congenital Malformation of the Bile Ducts: A Report of 3 Cases in 1 Family , J. Pediat. 1:496-501 ( (Oct.) ) 1932.Crossref 14. Gross, R. E.: The Surgery of Infancy and Childhood: Its Principles and Techniques , Philadelphia, W. B. Saunders Company, 1953. 15. Moore, T. C.: Congenital Atresia of the Extrahepatic Bile Ducts: Report of 31 Proved Cases , Surg., Gynec. & Obst. 96:215-225 ( (Feb.) ) 1953. 16. Myers, R. L.; Baggenstoss, A. H.; Logan, G. B., and Hallenbeck, G. A.: Congenital Atresia of the Extrahepatic Biliary Tract: A Clinical and Pathologic Study , Pediatrics 18:767-781 ( (Nov.) ) 1956. 17. Clatworthy, H. W., Jr., and McDonald, V. G., Jr.: The Diagnostic Laparotomy in Obstructive Jaundice in Infants , S. Clin. North America , pp. 1545-1554 ( (Dec.) ) 1956. 18. Harris, R. C.; Andersen, D. H., and Day, R. L.: Obstructive Jaundice in Infants with Normal Biliary Tree , Pediatrics 13:293-307 ( (April) ) 1954. 19. Day, R. L.: Personal communication to the authors. 20. Shorter, R. G.; Paton, A., and Pinniger, J. L.: Hepatic Jaundice, Quart. J. Med., to be published. 21. Stokes, J., Jr.; Wolman, I. J.; Blanchard, M. C., and Farquhar, J. D.: Viral Hepatitis in the Newborn: Clinical Features, Epidemiology, and Pathology , A.M.A. Am. J. Dis. Child. 82:213-216 ( (Aug.) ) 1951. 22. Hsia, D. Y.-Y.; Boggs, J. D.; Driscoll, S. G., and Gellis, S. S.: Prolonged Obstructive Jaundice in Infancy: V. The Genetic Components in Neonatal Hepatitis , A. M. A. J. Dis. Child. 95:485-491 ( (May) ) 1958. 23. Reiffenstuhl, G.: Infantile Lebercirrhose und ABO-Inkompatibilität , Schweiz. Ztschr. allg. Path. 16:197-209, 1953. 24. Zollinger, H. U.: Die biliäre Leberzirrhose im Säuglings- und Kleinkindalter und ihre Beziehung zum Morbus Haemolyticus Neonatorum , Helvet. paediat. acta 1 ( (Supp. 2) ):104-126, 1946. 25. Zeitlhofer, J., and Speiser, P.: Diffuse intraacinäre Lebercirrhose und Hydrops congenitus bei Rh-Incompatibilität , Oesterr. Ztschr. Kinderh. 5: 217-232 ( (Oct.) ) 1950. 26. Rosenfield, R. E.; Vogel, P., and Rosenthal, N.: The Antiglobulin Test: Technic and Practical Applications , Am. J. Clin. Path. 21:301-317 ( (April) ) 1951. 27. Ehrlich, J. C., and Ratner, I. M.: Congenital Cirrhosis of the Liver with Kernicterus: Report of 2 Cases in Siblings, with a Discussion of the Relationship to So-Called Neonatal Hepatitis and to Iso-Immunization Disease , Am. J. Path. 31:1013-1047 ( (Nov.) -Dec.) 1955. 28. Bain, G. O.; Wang, G. C., and Misanik, L. F.: Giant Cell Hepatitis Associated with Hereditary Spherocytosis , J. Pediat. 51:549-553 ( (Nov.) ) 1957.Crossref 29. Weisbrod, F. G.; Schiff, L.; Gall, E. A.; Cleveland, F. P., and Berman, J. R.: Needle Biopsy of the Liver: III. Experiences in the Differential Diagnosis of Jaundice , Gastroenterology 14:56-72 ( (Jan.) ) 1950. 30. Klemperer, P.; Killian, J. A., and Heyd, C. G.: The Pathology of "Icterus Catarrhalis," Arch. Path. 2:631-652 ( (Nov.) ) 1926. 31. Mann, F. C., and Magath, T. B.: The Production of Chronic Liver Insufficiency , Am. J. Physiol. 59:485 ( (Feb.) ) 1922. 32. Thaler, H.: Zur Histologie der Virushepatitis , Schweiz. Ztschr. allg. Path. 16:129-155, 1953. 33. Janeway, C. A.: Discussion , New England J. Med. 258:553 ( (March 13) ) 1958. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1959 American Medical Association. All Rights Reserved.
ISSN
0096-6916
DOI
10.1001/archpedi.1959.02070020361010
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Abstract

Abstract The presence of jaundice at birth or its onset early in the neonatal period may present formidable diagnostic difficulties to the pediatrician and to the pathologist, especially if the jaundice is prolonged and of the regurgitant form. If erythroblastosis fetalis is excluded, the differential diagnosis in most instances lies between congenital atresia of the bile ducts and neonatal (giant cell) hepatitis. Both these conditions have been the subject of studies in the literature,1-15 and it is apparent that many clinical and biochemical similarities exist between the two conditions. As a result, exploratory laparotomy is commonly undertaken in such cases to assess the patency of the biliary tree, and wedges of tissue resected from the liver are supplied to the pathologist for histologic examination. Since congenital atresia of the bile ducts and neonatal hepatitis are rare in clinical and pathologic practice, the purpose of this communication is to review the References 1. Craig, J. M., and Landing, B. H.: Form of Hepatitis in Neonatal Period Simulating Biliary Atresia , A.M.A. Arch. Path. 54:321-333 ( (Oct.) ) 1952. 2. Dible, J. H.; Hunt, W. E.; Pugh, V. W.; Steingold, L., and Wood, J. H. F.: Foetal and Neonatal Hepatitis and Its Sequelae , J. Path. & Bact. 67:195-206 ( (Jan.) ) 1954.Crossref 3. Schwartz, M. U.; Gilman, R. A.; Schwartz, M., and Settle, J.: Neonatal Hepatitis: Report of a Case Simulating Obstructive Jaundice , J. A. M. A. 155:557-559 ( (June 5) ) 1954.Crossref 4. Harris, R. C.; Andersen, D. H., and Day, R. L.: Obstructive Jaundice in Infants with Normal Biliary Tree , Pediatrics 13:293-307 ( (April) ) 1954. 5. Gellis, S. S.; Craig, J. M., and Hsia, D. Y.-Y.: Prolonged Obstructive Jaundice in Infancy: IV. Neonatal Hepatitis , A. M. A. Am. J. Dis. Child. 88:285-293 ( (Sept.) ) 1954. 6. Kiaer, W.: Hepatitis Foetalis , Ugesk. laeger 118:865-868 ( (July 26) ) 1956. 7. Krainin, P., and Lapan, B.: Neonatal Hepatitis in Siblings: Report of 2 Cases with Giant Multinucleated Liver Cells and Fatal Termination , J.A.M.A. 160:937-940 ( (March 17) ) 1956.Crossref 8. Thomson, J.: On Congenital Obliteration of the Bile Ducts , Edinburgh M. J. 37:523-531 ( (Dec.) ) 1891 9. 604-616 (Jan.) 10. 724-735 (Feb.) 1892. 11. Holmes, J. B.: Congenital Obliteration of the Bile Ducts: Diagnosis and Suggestions for Treatment , Am. J. Dis. Child. 11:405-431 ( (June) ) 1916. 12. Ladd, W. E.: Congenital Atresia and Stenosis of the Bile Ducts , J.A.M.A. 91:1082-1085 ( (Oct. 13) ) 1928.Crossref 13. Sweet, L. K.: Congenital Malformation of the Bile Ducts: A Report of 3 Cases in 1 Family , J. Pediat. 1:496-501 ( (Oct.) ) 1932.Crossref 14. Gross, R. E.: The Surgery of Infancy and Childhood: Its Principles and Techniques , Philadelphia, W. B. Saunders Company, 1953. 15. Moore, T. C.: Congenital Atresia of the Extrahepatic Bile Ducts: Report of 31 Proved Cases , Surg., Gynec. & Obst. 96:215-225 ( (Feb.) ) 1953. 16. Myers, R. L.; Baggenstoss, A. H.; Logan, G. B., and Hallenbeck, G. A.: Congenital Atresia of the Extrahepatic Biliary Tract: A Clinical and Pathologic Study , Pediatrics 18:767-781 ( (Nov.) ) 1956. 17. Clatworthy, H. W., Jr., and McDonald, V. G., Jr.: The Diagnostic Laparotomy in Obstructive Jaundice in Infants , S. Clin. North America , pp. 1545-1554 ( (Dec.) ) 1956. 18. Harris, R. C.; Andersen, D. H., and Day, R. L.: Obstructive Jaundice in Infants with Normal Biliary Tree , Pediatrics 13:293-307 ( (April) ) 1954. 19. Day, R. L.: Personal communication to the authors. 20. Shorter, R. G.; Paton, A., and Pinniger, J. L.: Hepatic Jaundice, Quart. J. Med., to be published. 21. Stokes, J., Jr.; Wolman, I. J.; Blanchard, M. C., and Farquhar, J. D.: Viral Hepatitis in the Newborn: Clinical Features, Epidemiology, and Pathology , A.M.A. Am. J. Dis. Child. 82:213-216 ( (Aug.) ) 1951. 22. Hsia, D. Y.-Y.; Boggs, J. D.; Driscoll, S. G., and Gellis, S. S.: Prolonged Obstructive Jaundice in Infancy: V. The Genetic Components in Neonatal Hepatitis , A. M. A. J. Dis. Child. 95:485-491 ( (May) ) 1958. 23. Reiffenstuhl, G.: Infantile Lebercirrhose und ABO-Inkompatibilität , Schweiz. Ztschr. allg. Path. 16:197-209, 1953. 24. Zollinger, H. U.: Die biliäre Leberzirrhose im Säuglings- und Kleinkindalter und ihre Beziehung zum Morbus Haemolyticus Neonatorum , Helvet. paediat. acta 1 ( (Supp. 2) ):104-126, 1946. 25. Zeitlhofer, J., and Speiser, P.: Diffuse intraacinäre Lebercirrhose und Hydrops congenitus bei Rh-Incompatibilität , Oesterr. Ztschr. Kinderh. 5: 217-232 ( (Oct.) ) 1950. 26. Rosenfield, R. E.; Vogel, P., and Rosenthal, N.: The Antiglobulin Test: Technic and Practical Applications , Am. J. Clin. Path. 21:301-317 ( (April) ) 1951. 27. Ehrlich, J. C., and Ratner, I. M.: Congenital Cirrhosis of the Liver with Kernicterus: Report of 2 Cases in Siblings, with a Discussion of the Relationship to So-Called Neonatal Hepatitis and to Iso-Immunization Disease , Am. J. Path. 31:1013-1047 ( (Nov.) -Dec.) 1955. 28. Bain, G. O.; Wang, G. C., and Misanik, L. F.: Giant Cell Hepatitis Associated with Hereditary Spherocytosis , J. Pediat. 51:549-553 ( (Nov.) ) 1957.Crossref 29. Weisbrod, F. G.; Schiff, L.; Gall, E. A.; Cleveland, F. P., and Berman, J. R.: Needle Biopsy of the Liver: III. Experiences in the Differential Diagnosis of Jaundice , Gastroenterology 14:56-72 ( (Jan.) ) 1950. 30. Klemperer, P.; Killian, J. A., and Heyd, C. G.: The Pathology of "Icterus Catarrhalis," Arch. Path. 2:631-652 ( (Nov.) ) 1926. 31. Mann, F. C., and Magath, T. B.: The Production of Chronic Liver Insufficiency , Am. J. Physiol. 59:485 ( (Feb.) ) 1922. 32. Thaler, H.: Zur Histologie der Virushepatitis , Schweiz. Ztschr. allg. Path. 16:129-155, 1953. 33. Janeway, C. A.: Discussion , New England J. Med. 258:553 ( (March 13) ) 1958.

Journal

A.M.A. Journal of Diseases of ChildrenAmerican Medical Association

Published: Sep 1, 1959

References