Bellomo-Brandao MA, Escanhoela CA, Meirelles LR, Porta G, Hessel G. Analysis of the histologic features in the differential diagnosis of intrahepatic neonatal cholestasis. World J Gastroenterol 2009; 15(4): 478-483 [PMID: 19152454 DOI: 10.3748/wjg.15.478]
Corresponding Author of This Article
Maria Angela Bellomo-Brandao, Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Rua Aristides Lobo, 789. Campinas, São Paulo 13083-060, Brazil. bellomobrandao@globo.com
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World J Gastroenterol. Jan 28, 2009; 15(4): 478-483 Published online Jan 28, 2009. doi: 10.3748/wjg.15.478
Analysis of the histologic features in the differential diagnosis of intrahepatic neonatal cholestasis
Maria Angela Bellomo-Brandao, Cecilia AF Escanhoela, Luciana R Meirelles, Gilda Porta, Gabriel Hessel
Maria Angela Bellomo-Brandao, Gabriel Hessel, Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP 13083-970, Brazil
Cecilia AF Escanhoela, Luciana R Meirelles, Department of Pathology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP 13083-970, Brazil
Gilda Porta, Department of Pediatrics, Children’s Institute of Medical School of the University of São Paulo (USP), São Paulo-SP 05403-000, Brazil
Author contributions: Bellomo-Brandao MA had responsibility for protocol development, collection of patients’ data, preliminary data analysis and writing the manuscript; Escanhoela CAF was responsible for histological analysis and helped to draft the manuscript; Meirelles LR was responsible for histological analysis; Porta G participated in the development of the protocol; Hessel G conceived of the study, and participated in its design and helped to draft the manuscript; All authors read and approved the final manuscript.
Correspondence to: Maria Angela Bellomo-Brandao, Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Rua Aristides Lobo, 789. Campinas, São Paulo 13083-060, Brazil. bellomobrandao@globo.com
Telephone: +55-19-35792998
Fax: +55-19-35217193
Received: September 10, 2008 Revised: November 7, 2008 Published online: January 28, 2009
Abstract
AIM: 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).
CONCLUSION: 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.
