Paucity of intrahepatic bile ducts in infancy--experience of a tertiary center.
BACKGROUND
Intrahepatic cholestasis secondary to paucity of bile duct is an alteration of the anatomic integrity of the biliary tract. Can be defined only histologically and, clinically, two categories are recognized: syndromic and non-syndromic, where the prognosis is generally more severe.


OBJECTIVE
To evaluate the history, clinical and biochemical characteristics, etiology and improvement of children who have paucity of intrahepatic bile duct followed at tertiary center.


METHODS
Eleven children with paucity of intrahepatic bile duct, followed at the Pediatric Hepatology Service of the University Hospital, Campinas, SP, Brazil, were evaluated in the period from 1986 to 2001.


RESULTS
Among the patients, three presented the syndromic and eight the non-syndromic form (two with alpha-1-antitrypsin deficiency, one with lues, one secondary to sepsis, three with probable etiology by cytomegalovirus and one without a definite etiology). Referral ranged from 31 to 1185 days. Birth weights ranged from 1920 g to 3590 g. Most of the patients presented pale stools. The median bile duct/portal tract ratio was 0.14. The majority of the children presented a favorable follow-up, regardless of the form of presentation.


CONCLUSIONS
Paucity of intrahepatic bile ducts should be considered in children with cholestasis and its differentiation from extrahepatic causes of neonatal cholestasis is important in order to avoid surgery. Diagnosis of non-syndromic form should not be regarded as unfavorable prognosis, as the evolution is probably related to the etiology in this form of presentation.
De Tommaso
Adriana Maria Alves
AM
Department of Pediatrics, Medical Sciences School, State University of Campinas, Campinas, SP, Brazil. amdetommaso@mpcnet.com.br
Kawasaki
Agnes Sumi
AS
Hessel
Gabriel
G
D001653:Bile Ducts, Intrahepatic / Q000002:abnormalities*; D002675:Child, Preschool; D002780:Cholestasis, Intrahepatic / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011379:Prognosis; D013577:Syndrome