Clinical analysis of 145 cases with infantile cholestasis

Objective This study was aimed at analyzing the clinical etiology, laboratory examination of infantile cholestasis, evaluating parameters in the differential diagnosis of intrahepatic cholestasis and biliary atresia (BA) .Methods The clinical characteristics, laboratory examinations and prognosis of the 145 hospitalised children in pediatric GI ward of Shengjing hospital from December 2007 to Febraury 2010 were analyzed.The data of BA and IHC groups were compared (145 cases diagnosed with intrahepatic cholestasis were collected and the clinical information was analyzed) .Results Compared with intrahepatic cholestasis cases, the incidences of hepatomegaly, acholic stools, increased GGT level, and the abnormal ultrasonography are significantly higher in BA.By analyzing the correlation between the CMV infection and infantile cholestasis, the clinical characteristics between positive and negative serology for CMV groups had no significant differences.Acholic stools has a higher sensitivity (88%) for diagnosis of BA.The high GGT (>300 U/L) , TC sign in ultrasonography had significant diagnostic value with higher specificity.Conclusion In the infantile cholestasis cases who presented acholic stools, hepatomegaly, a marked elevation in serum GGT (>300 U/L) , and positive TC sign combined with either abnormal size or abnormal contractility of the gallbladder, the most likely diagnosis was biliary atresia.Cytomegalovirus infection is one of the common reasons or just an "innocent by-stander".