Updates in Diagnosis and Management of Neonatal Cholestasis
Nazim Faisal Hamed *
Maternal and Child Health Care Center, Tabuk, Northern Border University, Arar, Saudi Arabia.
Alaa Saud M. Alyasi
Maternal and Child Health Care Center, Tabuk, Saudi Arabia.
Abdulaziz Abdulrahman Abdulqader Bedaiwi
King Salman Armed Forces Hospital, Tabuk, Saudi Arabia.
Turki Saleh Alshehri
King Salman Armed Forces Hospital, Tabuk, Saudi Arabia.
A. Asseri Muhand Ali
Tabuk University, Tabuk, Saudi Arabia.
Amer Faisal Alqaishesh Alenaze
King Khalid Hospital, Tabuk, Saudi Arabia.
Ihtifal Salamh Albanaqi
Maternity and Children Hospital in Arar, Saudi Arabia.
Almhnd Talal F. Alenezi
Maternity and Children Hospital in Arar, Saudi Arabia.
Khaled Abdulaziz Alanazi
Maternity and Children Hospital in Arar, Saudi Arabia.
Zaid Ibrahim Z. Al Kharaan
Price Sattam Bin Abdulaziz University, Saudi Arabia.
Kawthar Fawaz Mansor Alhamwan
Primary Health Care, Qurayyat, Saudi Arabia.
Mohammed Salem Slman Alshahrani
Clinical Pharmacy, Medical Services in the General Administration for Drug Control, Riyadh, Saudi Arabia.
Ahmed Basheer Ahmed Al Obaid
University of Imam Abdulrahman Bin Faisal, Dammam, Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
Neonatal jaundice refers to the yellow coloration of the skin and sclera of newborn babies that results from hyperbilirubinemia. About 50% of term and 80% of preterm babies develop jaundice in the first week of life. Jaundice is also a common cause of readmission to hospital after early discharge of newborn babies. Jaundice mainly develop due to two factors—the cessation of fetal hemoglobin as it is substituted with adult hemoglobin and the comparatively immature metabolic trails of the liver, which are incapable to conjugate and so expel bilirubin as quickly as an adult. This grounds an accretion of bilirubin in the blood (hyperbilirubinemia), causes the symptoms of jaundice. The typical results in an infant who has cholestasis are prolonged jaundice, scleral icterus, acholic stools, dark yellow urine, and hepatomegaly. Trying of diagnosis of children with jaundice must begin with the classification of serum bilirubin into total bilirubin and direct (or combined) bilirubin. Phototherapy is introduced based on risk influences in the nomogram and serum bilirubin levels. IV immunoglobulin is suggested for cumulative bilirubin levels from isoimmune hemolysis regardless of phototherapyand exchange transfusion is designated if there is a risk of neurologic dysfunction regardless beginning of phototherapy. This review aims to summarize current evidence regarding epidemiology, etiology, diagnosis and management of neonatal cholestasis.
Keywords: Neonatal jaundice, hyperbilirubinemia, cholestasis, Icterus