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A study on cholestasis in infants less than six months of age presenting to Lady Ridgeway Hospital for Children, Colombo

Authors:

Mohamed Infaq Mohamed Luthufdeen ,

The Queen Elizabeth Queen Mother Hospital, Margate, Kent, United Kingdom, LK
About Mohamed Infaq
Specialty Doctor in Paediatrics,The Queen Elizabeth Queen Mother Hospital, Margate, Kent, United Kingdom
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Samantha Waidyanatha

Lady Ridgeway Hospital for Children, Colombo, Sri Lanka, LK
About Samantha
Consultant Paediatrician, Lady Ridgeway Hospital for Children, Colombo, Sri Lanka
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Abstract

Objectives: To determine the common clinical presentations, common aetiological factors, average age at presentation and possible means of early detection of cholestasis by primary health care workers.

Method: This prospective, descriptive study analyzed  60 infants less than six months old who presented to Lady Ridgeway Hospital from October 2013 to January 2015 with evidence of cholestasis. 

Results: The common clinical features were jaundice (100%), hepatomegaly (83.3%), pale stools (76.6%), dark urine (61.6%) and splenomegaly (56.6%). The common causes were idiopathic neonatal hepatitis (INHS) (26.6%) and biliary atresia (26.6%). Nine cases of INHS were transient. Sepsis (15%), multifactorial (13.3%) and cytomegalovirus infection (6.6%) were the other frequent causes. The less frequent causes were Alagille syndrome (3.2%), birth asphyxia (1.6 %), progressive familial intrahepatic cholestasis (PFIC) (1.6%), biliary sludge due to haemolysis (1.6%), intestinal obstruction (1.6%) and multiple small gall bladder calculi (1.6%). The average age at presentation of infants with cholestasis was 64.2 days and the mean age at presentation of infants with cholestasis who were eventually diagnosed as biliary atresia was 81.8 days.

Conclusions: Jaundice, hepatomegaly and pale stools were the common clinical features on presentation. INHS and biliary atresia were the common causes of cholestasis. There was a significant delay in the presentation of cases of cholestasis due to primary health care failure.

 

How to Cite: Mohamed Luthufdeen, M.I. and Waidyanatha, S., 2016. A study on cholestasis in infants less than six months of age presenting to Lady Ridgeway Hospital for Children, Colombo. Sri Lanka Journal of Child Health, 45(1), pp.34–37. DOI: http://doi.org/10.4038/sljch.v45i1.8083
Published on 05 Mar 2016.
Peer Reviewed

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