title: Can neonatal hepatitis be more fatal than biliary atresia?
abstract: OBJECTIVE
  The basic problem in diagnosis of neonatal cholestasis (NC) is to differentiate biliary atresia (BA) from other non-obstructive disorders. Because if bile flow cannot be provided by surgery, BA leads to cirrhosis and death within the first year of life. The aim of the present study is to determine histopathological features that may help to differentiate BA from neonatal hepatitis (NH).
  
  
  METHODS
  This retrospective study was carried out on 105 liver biopsy specimens of 74 infants with NC who were diagnosed between 2003 and 2012.
  
  
  RESULTS
  The mean age was 76.5 ± 40.64 days. The most valuable biopsy findings for the discrimination between NH and BA, in decreasing order of importance, were ductular proliferation (p < 0.001), cholestasis in neoductuli (p < 0.001), fibrosis (p = 0.002), and extramedullar hematopoiesis (p = 0.02). While Kasai operations were performed in 19 cases, liver transplantation was performed in 10 cases. Survival rate among the death cases with BA was longer than the survival time of the death cases with NH (p = 0.023). Currently more children live with a close to normal quality of life with portoenterostomy and/or liver transplantation. On the contrary, NH can be more fatal with associated disorders such as growth retardation, specific infections, respiratory distress, and metabolic or endocrine diseases.
authors.affiliation: 1Department of Pathology, Tepecik Research Hospital , Izmir , Turkey.
authors.forename: Gulden
authors.initials: G
authors.lastname: Diniz
authors.forename: Hulya
authors.initials: H
authors.lastname: Tosun Yildirim
authors.forename: Sebnem
authors.initials: S
authors.lastname: Calkavur
authors.forename: Cigdem
authors.initials: C
authors.lastname: Ecevit
authors.forename: Ozgur
authors.initials: O
authors.lastname: Olukman
authors.forename: Ozlem
authors.initials: O
authors.lastname: Bekem Soylu
authors.forename: Safiye
authors.initials: S
authors.lastname: Aktas
mesh_terms: D001656:Biliary Atresia / Q000175:diagnosis* / Q000401:mortality*; D001706:Biopsy; D005260:Female; D006505:Hepatitis / Q000175:diagnosis* / Q000401:mortality*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000401:mortality; D008297:Male; D012189:Retrospective Studies
keywords: biliary atresia; differential diagnosis; neonatal hepatitis