Neonatal cholestatic hepatitis: etiology and evolution in patients attending the gastroenterology clinic

Abstract

Background: Neonatal cholestatic hepatitis is an inflammatory process of the hepatic parenchyma that usually presents with jaundice, acholia/hypocolia and coluria associated with cholestasis, which occurs in the first trimester of life and is associated with various etiologies: structural, infectious, toxic, idiopathic. or metabolic. Objective: To determine the etiology and evolution of patients with neonatal cholestatic hepatitis who attended the Gastroenterology service of the Children's Hospital "J.M de los Ríos" during the period 2017-2022. Patients and Methods: Descriptive, ambispective, observational, cross-sectional study in which patients ranging in age from newborns to 3 months of age with a diagnosis of cholestatic hepatitis were included, for which clinical records were reviewed. Data were analyzed using descriptive statistics, such as mean, median, standard deviation, 95% confidence intervals, absolute frequencies, and percentages. The ANOVA statistical test was applied and it was considered statistically significant when p<0.05. Results: Universe of 130 patients, 50.8% female, 49.2% male. The predominant etiology was structural/anatomical alterations (50.8%), infectious (TORCH) (39.2%), genetic (9.2%) and metabolic (0.8%). 100% of patients with infectious hepatitis progressed to resolution of cholestasis at 46.4±38.8 days. Kasai was performed on 67.4% of patients with biliary tract atresia (4.6 months on average), all with evolution to liver cirrhosis, 49% died from it. Conclusion: Neonatal cholestatic hepatitis is an entity where the etiological diagnosis is usually late, so it is imperative to know its etiology and evolution to avoid progression and complications that can result in the death of patients who suffer from them.