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Biliary Atresia or neonatal hepatitis a condition that may develop
in the first weeks after birth in which there is damage
to the bile ducts, resulting in an enlarged liver and jaundice.
Surgery is needed in order to correct the condition and establish
the flow of bile.
Cause of Neonatal hepatitis
Hepatitis in the neonatal period presumed to be due to a variety of causes, chiefly viral; characterised by direct and indirect bilirubinaemia, hepatocellular degeneration, and appearance of multinucleated giant cells; may be difficult to distinguish from biliary atresia, but is more likely to end with recovery, although cirrhosis may develop.
Treatment of Neonatal hepatitis
The treatment of neonatal hepatitis involves management of the symptoms and preventing any further complications. This involves the use of certain medicines to increase bile flow and relieve the severe itching cause by the build up of bile in skin. Vitamin supplements are used because reduced bile leads to difficulties in absorption of vitamins A, D, E, and K.
Neonatal hepatitis patients are often on specific diets that include very high caloric intake and formulas that are rich in fats. A small number of hepatitis patients may develop severe liver damage and will need a liver transplant.
Investigation and outcome of neonatal hepatitis in infants with hypopituitarism
Congenital hypopituitarism is a recognized cause of neonatal hepatitis, but the diagnosis may be difficult to establish even if clinically suspected. In order to determine the natural history of this disorder, the outcome of 12 infants with neonatal hepatitis secondary to hypopituitarism is reviewed.
The clinical diagnosis of hypopituitarism was established on a combination of features, which include dysmorphism (4 infants), optic nerve hypoplasia (8 infants), micropenis (5 male infants) and recurrent hypoglycaemia (blood glucose <2.4 mmol/l (8 infants)). Endocrine investigation revealed low free thyroxine (T4) levels (<10 pmol/l), with normal thyroid stimulating hormone (TSH) levels (0.4-4.5 mU/l) (11 infants), and serum cortisol levels which were inappropriately low (<200 nmol/l).
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