Abstract

LOPEZ PANQUEVA, Rocío del Pilar  and  JARAMILLO BARBERI, Lina Eugenia. Neonatal and Infantile Cholestasis: An Approach to Histopathological Diagnosis. Rev Col Gastroenterol [online]. 2014, vol.29, n.3, pp.304-311. ISSN 0120-9957.

Although the role of liver biopsies is changing with the development of new diagnostic methods and advances in imaging techniques, non-invasive biomarkers, proteomic and genomic studies, a liver biopsy performed at the right time and with appropriate indications continues to be an important tool for assessment and diagnosis of children with cholestasis. This is equally true in the neonatal period, in early childhood, and in late childhood not only for determination of an etiology and establishing a prognosis, but also for guiding treatment of the patient (1). There are multiple causes and morphological patterns that may be related to a genetic defect in aspects of hepatic metabolism including synthesis of bile acids, formation and function of membrane transporters, and alterations in the development of the bile ducts. Many of these may overlap and should be interpreted in conjunction with clinical, genetic and laboratory findings. Inherited syndromes that produce intrahepatic cholestasis and biliary atresia are the most common causes of chronic liver disease and the leading indication for liver transplantation in children. The approach we present here emphasizes the close cooperation that should exist between pediatricians, gastroenterologists, pediatric surgeons and pathologists for proper identification of many of the cholestatic diseases that can affect this age group. Subsequent surgical or medical management may include liver transplantation (2, 3).

Keywords : Cholestasis; liver biopsy; biliary atresia; neonatal hepatitis, Alpha-1 antitrypsin; ductopenia.

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