Analysis of the histologic features in the differential diagnosis of intrahepatic neonatal cholestasis.
OBJECTIVE
To compare the histologic features of the liver in intrahepatic neonatal cholestasis (IHNC) with infectious, genetic-endocrine-metabolic, and idiopathic etiologies.


METHODS
Liver biopsies from 86 infants with IHNC were evaluated. The inclusion criteria consisted of jaundice beginning at 3 mo of age and a hepatic biopsy during the 1st year of life. The following histologic features were evaluated: cholestasis, eosinophilia, giant cells, erythropoiesis, siderosis, portal fibrosis, and the presence of a septum.


RESULTS
Based on the diagnosis, patients were classified into three groups: group 1 (infectious; n=18), group 2 (genetic-endocrine-metabolic; n=18), and group 3 (idiopathic; n=50). There were no significant differences with respect to the following variables: cholestasis, eosinophilia, giant cells, siderosis, portal fibrosis, and presence of a septum. A significant difference was observed with respect to erythropoiesis, which was more severe in group 1 (Fisher's exact test, P=0.016).


CONCLUSIONS
A significant difference was observed in IHNC of infectious etiology, in which erythropoiesis was more severe than that in genetic-endocrine-metabolic and idiopathic etiologies, whereas there were no significant differences among cholestasis, eosinophilia, giant cells, siderosis, portal fibrosis, and the presence of a septum.
Bellomo-Brandao
Maria Angela
MA
Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Rua Aristides Lobo, 789. Campinas, Sao Paulo 13083-060, Brazil. bellomobrandao@globo.com
Escanhoela
Cecilia A F
CA
Meirelles
Luciana R
LR
Porta
Gilda
G
Hessel
Gabriel
G
D001706:Biopsy; D002780:Cholestasis, Intrahepatic / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D003937:Diagnosis, Differential; D004802:Eosinophilia / Q000473:pathology; D004920:Erythropoiesis; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000473:pathology; D008297:Male