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Neonatal Hepatitis and Its Relation to Viral Hepatitis of Mother: A Review of the Problem

Neonatal Hepatitis and Its Relation to Viral Hepatitis of Mother: A Review of the Problem Abstract Giant cell hepatitis of infancy (for some of the other terms used for this condition see Fienberg1), one of the causes of jaundice in early life, is a disorder of unknown etiology which has attracted much attention in recent years. It is characterized by the presence, in the liver chiefly of young infants, of varying numbers of multinucleated giant cells of hepatocellular origin and by the absence of any other demonstrable pathological condition which could be held responsible for either the jaundice, when present, or for the development of the characteristic giant cells. This definition, however, probably covers only one, perhaps the most obvious, group of cases, as will be shown later in this paper, since it excludes, on the one hand, those undoubted cases of viral hepatitis in young infants where no giant cells have been seen2-19 and, on the other, certain pathological conditions of the infant's References 1. Fienberg, R.: Perinatal Idiopathic Hemochromatosis: Giant Cell Hepatitis Interpreted as an Inborn Error of Metabolism , Amer. J. Clin. Path. 33:480-491, 1960. 2. Wallgren, A.: An Epidemic of Catarrhal Jaundice (Epidemic Hepatitis) , Acta Med. Scand. , (Suppl. 26) , pp. 118-123, 1928. 3. Almering, M.: Über Hepatitis epidemica (sog. Icterus catarrhalis) im Säuglingsalter , Arch. Kinderheilk. 122:35-48, 1941. 4. Ponticaccia, L.: G. Clin. Med. 12:1, 1946, quoted by de Matteis.15 5. Wood, D. A., and Black, M. R.: Further Notes on the Pathology of Acute Epidemic Hepatitis and Homologous Serum Jaundice , Amer. J. Clin. Path. 16:746-751, 1946. 6. Bruyn, H. B.: Homologous Serum Hepatitis Following Transfusion in an Infant , J. Pediat. 31: 60-69, 1947.Crossref 7. Apley, J., and Wallis, H. R. E.: Homologous Serum Jaundice in Infancy , Brit. Med. J. 1:197-198, 1948.Crossref 8. Moloshok, R. E.; Karelitz, S., and Strauss, L.: Homologous Serum Hepatitis in Infants and Children , Pediatrics 3:651-666, 1949. 9. Schmidt, E. C. H., and Lee, C. H.: Fatal Homologous Serum Hepatitis in a Young Infant: Case Report with Necropsy Studies , J. Pediat. 34: 226-231, 1949.Crossref 10. Williams, R. R., and Gaber, B.: The Fulminant Form of Epidemic Hepatitis in a 2-Month-Old Infant , J. Pediat. 35:244-248, 1949.Crossref 11. Traisman, A. S.; Wheeler, R. C., and Fager, D. B.: Virus Hepatitis in Infancy , J. Pediat. 37: 174-182, 1950.Crossref 12. Mai, H.: Die wichtigsten Ikterusformen des Säuglingsalters , Muenchen. Med. Wschr. 93:1627-1634, 1951. 13. Méan, A.: Die Hepatitis epidemica im Säuglingsalter mit besonderer Berücksichtigung der Differentialdiagnose , Ann. Paediat. (Basel) 176: 225-269, 1951. 14. Lanbrinakos, J., and Papathéodorou, P.: Sur quelques cas d'atrophie jaune aigue du foie consécutive à une hépatite épidémique chez des nourrissons , Helv. Paediat. Acta 9:64-68, 1954. 15. de Matteis, F.: L'epatite virale del lattante: Rilievi epidemiologici e clinici ed evoluzione del quadro istologico epatico; studio per punture biopsiche seriate del fegato (primo contributo della letteratura) , Clin. Pediat. (Bologna) 36:101-148, 1954. 16. de Matteis, F., and Raggio, G.: Rilievi epidemiologici, clinici, funzionali e biopsici su tre epidemie di epatite infettiva del lattante , Minerva Pediat . 6: 794-830, 1954. 17. Collins, D. L.: Neonatal Hepatitis Including a Case Associated with Maternal Hepatitis During Pregnancy , Canad. Med. Ass. J. 75:828-832, 1956. 18. Gál, G.: Beiträge zur Pathologie der Hepatitis im Säuglingsalter , Acta Morph. Acad. Sci. Hung. 7:423-435, 1956-1957. 19. Peace, R.: Fatal Hepatitis and Cirrhosis in Infancy: A Critical Analysis of 32 Cases Studied at Necropsy , A.M.A. Arch. Path. 61:107-119, 1956. 20. Zollinger, H. U.: Die biliare Leberzirrhose im Säuglings- und Kleinkindalter und ihre Beziehung zum Morbus haemolyticus neonatorum , Helv. Paediat. Acta. 1( (Suppl.2) ):104-126, 1946. 21. Harris, R., in discussion of Stokes, et al.52 22. Anderson, D. H., in discussion of Stokes et al.52 23. Harris, R. C.; Anderson, D. H., and Day, R. C.: Obstructive Jaundice in Infants with Normal Biliary Tree , Pediatrics 13:293-307, 1954. 24. Reiffenstuhl, G. U.: Infantile Lebercirrhose und ABO-Inkompatibilität , Schweiz. Z. Allg. Path. 16:197-209, 1953. 25. Bain, G. O.; Wang, G. O., and Misanik, L. F.: Giant Cell Hepatitis Associated with Hereditary Spherocytosis , J. Pediat. 51:549-553, 1957.Crossref 26. 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 Isoimmunization Disease , Amer. J. Path. 31:1013-1047, 1955. 27. 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, 1956.Crossref 28. Craig, J. M., and Landing, B. H.: Form of Hepatitis in Neonatal Period Simulating Biliary Atresia , A.M.A. Arch. Path. 54:321-333, 1952. 29. Craig, J. M.; Gellis, S. S., and Hsia, D. Y. Y.: Cirrhosis of the Liver in Infants and Children , A.M.A. Amer. J. Dis. Child. 90:299-322, 1955. 30. Stowens, D., in discussion of Kaye, R.; Wagner, B. M.; Koop, C. E., and Hope, J. W.: Needle Biopsy of the Liver and Cholangiography as Aids in the Diagnosis of Prolonged Jaundice in Infancy, Society Transactions , A.M.A. J. Dis. Child. 94: 417-420, 1957. 31. Stowens, D.: Pediatric Pathology , Baltimore, Williams & Wilkins Company, 1959, p. 494. 32. Kaye, R.; Koop, C. E.; Wagner, B. M.; Picou, D., and Yakovac, W. C.: Needle Biopsy of the Liver: An Aid in the Differential Diagnosis of Prolonged Jaundice in Infancy , A.M.A. J. Dis. Child. 98:699-709, 1959.Crossref 33. Ruebner, B.: The Pathology of Neonatal Hepatitis , Amer. J. Path. 36:151-163, 1960. 34. Binder, A.: Über Riesenzellenbildung bei kongenitaler Lues der Leber , Virchow. Arch. Path. Anat. 127:44-63, 1904.Crossref 35. Oppenheimer, R.: Riesenleberzellen bei angeborener Syphilis , Virchow. Arch. Path. Anat. 182: 237-257, 1905.Crossref 36. Lonicer, M.: Über Riesenzellbildung in der Leber bei Lues congenita , Zieglers Beitr. Path. Anat. 39:539-562, 1906. 37. Herxheimer, G.: Zur pathologischen Anatomie der kongenitalen Syphilis , Ergebn. Allg. Path. 12: 499-575, 1908. 38. Popper, H. P., and Schaffner, F.: Liver: Structure and Function , New York, McGraw-Hill Book Company, Inc., 1957. 39. Sherlock, S.: Diseases of the Liver and Biliary System , Ed. 2, Oxford, England, Blackwell Scientific Publications, 1958, p. 453. 40. Weller, T. A.; Macauley, J. C.; Craig, J. M., and Wirth, P.: Isolation of Intranuclear Inclusion Producing Agents from Infants with Illnesses Resembling Cytomegalic Inclusion Disease , Proc. Soc. Exp. Biol. Med. 94:4-12, 1957.Crossref 41. Scully, R. E., in Case Records of the Massachusetts General Hospital: Case 44111 , New Engl. J. Med. 258:546-554, 1958.Crossref 42. Potter, E. L.: Pathology of the Fetus and Infant , Ed. 2, Chicago, Year Book Medical Publishers, Inc., 1961. 43. Janeway, C. A., in Case Records of the Massachusetts General Hospital: Case 44111 , New Engl. J. Med. 258:546-554, 1958.Crossref 44. Zuelzer, W. W., and Brown, A. K.: Neonatal Jaundice: A Review , Amer. J. Dis. Child. 101:87-127, 1961.Crossref 45. Gruber, G. B.: Spezielle Infektionsfolgen der Leber: VIII. Lues , in Handbuch der speziellen pathologischen Anatomie und Histologie , Vol. V, (Part 1) , edited by F. Henke, and O. Lubarsch, Berlin, Springer-Verlag, 1930, p. 578. 46. Beneke, R.: Zur Histologie und Genese subakuter "gelber Leberatrophie" im Kindesalter , Beitr. Path. Anat. 88:538-594, 1932. 47. Roulet, F.: Zur pathologischen Anatomie der Hepatitis epidemica , Ann. Paediat. (Basel) 159: 283-287, 1942. 48. Roulet, F.: Über die akute gelbe Leberatrophie im Kindesalter, zugleich ein Beitrag zur Kenntnis der pathologischen Anatomie der Hepatitis epidemica , Virchow. Arch. Path. Anat. 310:436-457, 1943.Crossref 49. Bodian, M., and Newns, G. H.: Hépatite néonatale , Arch. Franc. Pediat. 10:169-173, 1953. 50. Dible, J. H.: Foetal and Neonatal Hepatitis and Its Sequelae , Schweiz. Z. Allg. Path. 16:389-391, 1953. 51. 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, 1954.Crossref 52. 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. Amer. J. Dis. Child. 82:213-216, 1951. 53. Stokes, J., Jr.; Berk, J. E.; Malamut, L. L.; Drake, M. E.; Barondess, J. A.; Bashe, W. J.; Wolman, I. J.; Farquhar, J. D.; Bevan, B.; Drummond, R. J.; Maycock, W. D.; Capps, R. B., and Bennett, A. M.: The Carrier State in Viral Hepatitis , J.A.M.A. 154:1059-1065, 1954.Crossref 54. Schaffer, A. J.: Diseases of the Newborn , Philadelphia, W. B. Saunders Company, 1960. 55. Bellin, L. B., and Bailit, I. W.: Congenital Cirrhosis of the Liver Associated with Infectious Hepatitis of Pregnancy , J. Pediat. 40:60-63, 1952.Crossref 56. Janeway, C. A., in discussion of Stokes, J., Jr.; Wolman, I. J.; Blanchard, M. C., and Farquhar, J. D.52 57. Hsia, D. Y. Y.; Taylor, R. G., and Gellis, S. S.: Long Term Follow-Up Study on Infectious Hepatitis During Pregnancy , J. Pediat. 41:13-17, 1952.Crossref 58. Gellis, S. S.: Editor's Comment, Yearbook of Pediatrics, 1954/1955 , Chicago, Year Book Medical Publishers, Inc., 1954, p. 102. 59. Gellis, S. S.; Craig, J. M., and Hsia, D. Y. Y.: Prolonged Obstructive Jaundice in Infancy: IV. Neonatal Hepatitis , A.M.A. Amer. J. Dis. Child. 88:285-293, 1954. 60. Scott, R. B.; Wilkins, W., and Kessler, A.: Viral Hepatitis in Early Infancy: Report of 3 Fatal Cases in Siblings Simulating Biliary Atresia , Pediatrics 13:447-452, 1954. 61. Beard, A. G.: Hepatitis in 3 Siblings: Possibility of Intrauterine Transmission , J. Pediat. 49: 454-460, 1956.Crossref 62. 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, 1958.Crossref 63. Havens, W. P., Jr.: Viral Hepatitis , Yale J. Biol. Med. 34:314-328, 1961/1962. 64. Boggs, J. D.; Bigler, J. A.; Garris, C., and Kidd, J. M.: Neonatal Hepatitis: Studies in Human Volunteers to Evaluate the Presence of Transmissible Disease-Producing Factors , A.M.A. J. Dis. Child. 93:82, 1957. 65. Boggs, J. D.: Prolonged Jaundice in Infancy Produced by Neonatal Hepatitis , Quart. Bull. Northw. Univ. Med. Sch. 31:6-8, 1957. 66. Smetana, H. F., and Johnson, F. B.: The Histopathology of Hepatitis of the Neonatal Period , Amer. J. Clin. Path. 24:82, 1954, Supplement on International Congress of Clinical Pathology. 67. Smetana, H. F., and Johnson, F. B.: Neonatal Jaundice with Giant Cell Transformation of the Hepatic Parenchyma , Amer. J. Path. 31:747-755, 1955. 68. Willis, R. A.: Borderland of Embryology and Pathology , London, Butterworth & Co., Ltd., 1958, p. 457. 69. Klebs, E.: Die allgemeine Pathologie, oder die Lehre von den Ursachen und dem Wesen der Krankheitsprocesse: Vol. II. Störungen des Baues und der Zusammensetzung (allgemeine pathologische Morphologie), Jena, Gustav Fischer Verlag, 1889, p. 364. 70. Pignataro, L.: Un'epidemia d'ittero , Policlinico [Prat.] 24:287-289, 1917. 71. Langovoi, N.: On the Question of Different Types of Jaundice in Early Childhood , in Twenty Years of Work of the Medical-Sanitary Department of the Kremlin , Moscow, Medgiz, 1939, pp. 71-74. 72. Olin, G.: A Hepatitis Epidemic Presumably Spread by Water , Acta Med. Scand. 128 ( (Suppl. 196) ):381-391, 1947.Crossref 73. Tareev, E. M.: Botkin's Disease and Cirrhosis of the Liver , Sovet. Med. 22:9-21, 1958. 74. Toscano, F., and Rossi, G.: Epatopatia in nato da madre affetta da epatite epidemica in gravidanza (studio anatomo-clinico) , Pediatria (Nap.) 58:209-218, 1950. 75. Lipman, B. L.: Fatal Hepatitis Occurring in an Infant 3 Months of Age , J.A.M.A. 144:1090, 1950.Crossref 76. Moncrieff, A.: Infection in the Newborn Baby , Brit. Med. J. 1:1-7, 1953.Crossref 77. Aikat, B. K., and Sen Gupta, K. P.: Fetal and Neonatal Hepatitis , Indian J. Med. Sci. 10: 169-176, 1956. 78. Shapiro, V. S.: Primary Hepatitis in Children Associated with Infectious Hepatitis of the Mother During Pregnancy , Sovet. Med. 22:42-47, 1958. 79. Shorter, R. G.; Baggenstoss, A. H., and Logan, G. B.: Neonatal Hepatitis , A.M.A. J. Dis. Child. 98:359-369, 1959. 80. Shorter, R. G.; Logan, G. B.; Bollman, J. L., and Baggenstoss, A. H.: Neonatal Hepatitis , Proc. Mayo Clin. 36:148-157, 1961. 81. Ruggieri, B. A.; Baggenstoss, A. H., and Logan, G. B.: Juvenile Cirrhosis: A Clinicopathologic Study of 27 Cases , A.M.A. J. Dis. Child. 94:64-76, 1957.Crossref 82. Singh, A.; Jolly, S. S., and Kumar, L. R.: Indian Childhood Cirrhosis , Lancet 1:587-591, 1961.Crossref 83. Gruber, A. E.: Die riesenzellige Leberzirrhose des Neugeborenen , Geburtsh. Frauenheilk. 17:381-387, 1957. 84. Frisell, E., and Lundquist, C. W.: "Jättecellshepatit" hos spädbarn , Nord. Med. 54:1459-1461, 1955. 85. Roth, D., and Duncan, P. A.: Primary Carcinoma of the Liver After Giant-Cell Hepatitis of Infancy , Cancer 8:986-991, 1955.Crossref 86. Bowden, D. H., and Donohue, W. L.: Jaundice in the Neonatal Period , Amer. J. Med. Sci. 230:305-316, 1955.Crossref 87. Rapoport, M.: The Liver , in Textbook of Pediatrics , edited by W. E. Nelson, Philadelphia, W. B. Saunders Company, 1959, p. 704. 88. Claireaux, A. E.: Neonatal Hyperbilirubinemia , Brit. Med. J. 1:1528-1534, 1960.Crossref 89. Ellegast, H.; Gumpesberger, G., and Wewalka, F.: Einfluss einer Hepatitis in der Schwangerschaft auf das Kind , Wien. Klin. Wschr. 66:507-511, 1954. 90. 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, 1954.Crossref 91. Saint-Vel, O.: Note sur une forme d'ictère grave , Gaz. Hop. Civils Militaires 35:538-539, 1862. 92. Martin, R., and Ferguson, F. C.: Infectious Hepatitis Associated with Pregnancy , New Engl. J. Med. 237:114-117, 1947.Crossref 93. Zondek, B., and Bromberg, Y. M.: Infectious Hepatitis in Pregnancy , J. Mount Sinai Hosp. N.Y. 14:222-243, 1947. 94. Dill, L. V.: Acute Yellow Atrophy of the Liver Associated with Pregnancy: A Review of the Literature and 6 Cases , Obstet. Gynec. Survey 5:139-158, 1950.Crossref 95. Kellogg, C. J., and Wesp, J. E.: Infectious Hepatitis During Pregnancy and Its Effect upon the Fetus , Amer. J. Obstet. Gynec. 62:1153-1156, 1951. 96. Mickal, A.: Infectious Hepatitis in Pregnancy , Amer. J. Obstet. Gynec. 62:409-414, 1951. 97. Martini, G. A.: Hepatitis und Schwangerschaft , Schweiz. Z. Allg. Path. 16:475-482, 1953. 98. Martini, G. A.; von Harnack, G. A., and Napp, J. H.: Hepatitis und Schwangerschaft: Die Auswirkung der Hepatitis auf die Mutter , Deutsch. Med. Wschr. 78:661-665, 1953.Crossref 99. Frucht, H. L., and Metcalfe, J.: Mortality and Late Results of Infectious Hepatitis in Pregnant Women , New Engl. J. Med. 251:1094-1096, 1954.Crossref 100. Mansell, R. V.: Infectious Hepatitis in the First Trimester of Pregnancy and Its Effect on the Fetus , Amer. J. Obstet. Gynec. 69:1136-1139, 1955. 101. Ezes, H., and Bourdon, R.: Les Hépatites ictérigènes graves d'allure virale au cours de la gestation (synthèse critique de 36 observations recueillies de 1952 à 1956) , Gynec. Obstet. (Par.) 55:288-311, 1956. 102. Phatak, L. V., and Patil, K.: Study of Infective Hepatitis in Pregnancy , Indian J. Med. Sci. 10:593-601, 1956. 103. Martini, G. A., in discussion in Hepatitis Frontiers , edited by F. W. Hartmann, G. A. Logrippo, J. G. Mateer, and J. Barron, Boston, Little, Brown & Company, 1957, pp. 179-180. 104. Vincent, C. R.: Jaundice in Pregnancy: A Review from the Charity Hospital, New Orleans, 1941-1956 , Obstet. (N.Y.) Gynec. 9:595-598, 1957. 105. Cahill, K. M.: Hepatitis in Pregnancy , Surg. Gynec. Obstet. 114:545-552, 1962. 106. Denning, H., and Bruckmann, R.: Virushepatitis und Schwangerschaft , Muenchen. Med. Wschr. 103:1817-1821, 1961. 107. Thorling, L.: Jaundice in Pregnancy , Acta Med. Scand. 151 ( (Suppl. 302) ):1-123, 1955. 108. Blattner, R. J., and Heys, F. M.: Role of Viruses in the Etiology of Congenital Malformations , Progr. Med. Virol. 3:311-362, 1961. 109. Schafer, I. A., and Stokes, J., Jr.: Viral Hepatitis , Courrier 7:1-15, 1957. 110. Holfeld, H.: Über schwere Leberdystrophie bei einem Neugeborenen, gleichzeitig ein Beitrag zur diaplazentaren Hepatitisübertragung , Arch. Kinderheilk. 149:270-277, 1954. 111. Reinke, F.: Über directe Kernteilungen und Kernschwund der menschlichen Leberzellen , Verh. Anat. Ges. 12:86-89, 1898. 112. Oberndorfer: Pathologisch-anatomische Erfahrungen über innere Krankheiten im Felde , Muenchen. Med. Wschr. 65:1189-1191, 1918. 113. Klemperer, P.; Killian, J. A., and Heyd, C. G.: The Pathology of "Icterus Catarrhalis," Arch. Path. Lab. Med. 2:631-652, 1926. 114. Herxheimer, G., and Thölldte, M.: Regeneration und Hypertrophie der Leber , in Henke, F., and Lubarsch, O., Editors: Handbuch der speziellen pathologischen Anatomie und Histologie , Vol. V, (Part 1) , Berlin, Springer-Verlag, 1930, pp. 988-1037. 115. Lucké, B., and Mallory: The Fulminant Form of Epidemic Hepatitis , Amer. J. Path. 22: 867-945, 1946. 116. Dubin, I. N., quoted by Dible.50 117. Smetana, H. F.: Pathologic Anatomy of Early Stage of Viral Hepatitis , in Hepatitis Frontiers , edited by F. W. Hartman, G. A. Logrippo, J. G. Mateer, and J. Barron, Boston, Little, Brown & Company, 1957, pp. 77-111. 118. Czenkár, B.: Pathologie der Riesenzellenhepatitis in Neugeborenen und Säuglingen , Virchow. Arch. Path. Anat. 331:696-701, 1958.Crossref 119. Fajers, C. M., Falkmer, S.; Frisell, E., and Pehrson, M.: Primary Carcinoma of the Liver and Giant-Cell Hepatitis in Infancy , Acta Paediat . 49:96-110, 1960.Crossref 120. Gall, E. A.: The Diagnosis of Hepatitis by Needle Biopsy, in Hepatitis Frontiers,113 p. 475-498. 121. Schmincke, A.: Pathologische Anatomie der Leber, der Gallengänge, der Gallenblase und des Pankreas , in Handbuch der allgemeinen pathologischen Anatomie des Kindesalters , edited by H. Brüning and E. Schwalbe, München, J. F. Bergmann, 1924, p. 1221. 122. Kasai, M.; Yakovac, W. C., and Koop, C. E.: Liver in Congenital Biliary Atresia and Neonatal Hepatitis , Arch. Path. 74:152-162, 1962. 123. MacCallum, F. O.: The Etiology of Hepatitis, in Hepatitis Frontiers.113 124. Kibrick, S., and Benirschke, K.: Severe Generalized Disease (Encephalohepatomyocarditis) Occurring in the Newborn Period and Due to Infection with Coxsackie Virus, Group B: Evidence of Intrauterine Infection with This Agent , Pediatrics 22:857-875, 1958. 125. 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Anat. 251:464-493, 1924.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Neonatal Hepatitis and Its Relation to Viral Hepatitis of Mother: A Review of the Problem

American Journal of Diseases of Children , Volume 105 (4) – Apr 1, 1963

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Abstract

Abstract Giant cell hepatitis of infancy (for some of the other terms used for this condition see Fienberg1), one of the causes of jaundice in early life, is a disorder of unknown etiology which has attracted much attention in recent years. It is characterized by the presence, in the liver chiefly of young infants, of varying numbers of multinucleated giant cells of hepatocellular origin and by the absence of any other demonstrable pathological condition which could be held responsible for either the jaundice, when present, or for the development of the characteristic giant cells. This definition, however, probably covers only one, perhaps the most obvious, group of cases, as will be shown later in this paper, since it excludes, on the one hand, those undoubted cases of viral hepatitis in young infants where no giant cells have been seen2-19 and, on the other, certain pathological conditions of the infant's References 1. 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Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Apr 1, 1963

References