Direct hyperbilirubinemia in infants with congenital heart disease

Direct hyperbilirubinemia in infants with congenital heart disease Neonatal jaundice is a common symptom in the first 2 weeks after birth, and occurs in 2.4–15% of newborn infants. Most infants with jaundice have unconjugated, indirect hyperbilirubinemia (HB) without any pathological implication. In contrast, cholestatic jaundice with direct hyperbilirubinemia (D‐HB) in infants is regarded as abnormal, and recent guidelines recommend that neonates with jaundice lasting >2–3 weeks of age should be evaluated for D‐HB and, if present, should undergo further evaluation for cholestasis. The main reason for this early evaluation is early detection and prompt Kasai operation for biliary atresia (BA).Biliary atresia is a progressive obstructive disease of the biliary tract, affecting 0.5–2.9 per 10 000 births. Congenital structural anomalies are relatively common in infants with BA: the incidence ranges from 13.4% to 20.3%. Of the congenital anomalies coexisting with BA, congenital heart disease (CHD) is one of the major ones, and is found in 6.3–15% of infants with BA. Therefore, neonates with CHD are thought to be at high risk for BA. The characteristics of cholestatic jaundice or D‐HB, a first clue for the suspicion and diagnosis of BA in infants with CHD, has not been previously reported.Thus, the aim of the study was to clarify the characteristics (i.e. incidence, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Pediatrics International Wiley

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
Copyright © 2018 Japan Pediatric Society
ISSN
1328-8067
eISSN
1442-200X
D.O.I.
10.1111/ped.13462
Publisher site
See Article on Publisher Site

Abstract

Neonatal jaundice is a common symptom in the first 2 weeks after birth, and occurs in 2.4–15% of newborn infants. Most infants with jaundice have unconjugated, indirect hyperbilirubinemia (HB) without any pathological implication. In contrast, cholestatic jaundice with direct hyperbilirubinemia (D‐HB) in infants is regarded as abnormal, and recent guidelines recommend that neonates with jaundice lasting >2–3 weeks of age should be evaluated for D‐HB and, if present, should undergo further evaluation for cholestasis. The main reason for this early evaluation is early detection and prompt Kasai operation for biliary atresia (BA).Biliary atresia is a progressive obstructive disease of the biliary tract, affecting 0.5–2.9 per 10 000 births. Congenital structural anomalies are relatively common in infants with BA: the incidence ranges from 13.4% to 20.3%. Of the congenital anomalies coexisting with BA, congenital heart disease (CHD) is one of the major ones, and is found in 6.3–15% of infants with BA. Therefore, neonates with CHD are thought to be at high risk for BA. The characteristics of cholestatic jaundice or D‐HB, a first clue for the suspicion and diagnosis of BA in infants with CHD, has not been previously reported.Thus, the aim of the study was to clarify the characteristics (i.e. incidence,

Journal

Pediatrics InternationalWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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