Neonatal Cholestasis ( Conjugated Jaundice )

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Neonatal Cholestasis ( Conjugated Jaundice )

Direct bilirubin > 2 mg/dl
or
>15 % of Total bilirubin

=> Jaundice + Clay Coloured Stools + Dark yellow urine.

Causes :

1. Medical -

• MC cause - Neonatal Hepatitis (because of TORCH)
• Sepsis
• Galactosemia
• Alpha 1 Antitripsin deficiency
• Neonatal Hemochromatosis

2. Surgical -

• Extra Hepatic biliary atresia (should be operated in 1st 8 wks - Kasai Operation - else 80% die)
Gamma glutamyl transferase (GGT) is 10 times higher in surgical

In Biliary Atresia

1. USG : 

• GB Absent
• Triangular Cord

2. HIDA scan - IV dye

Not excreted into gut in biliary atresia

3. Gold Standard - PerOperative Cholangiography

MRCP is as good as PerOp Cholangiography


Galacosemia 

Galactose 1-phosphate uridyltransferase is deficient.

Therefore Galactose 1 Phosphate Increase - Hepatotoxic

Triad :

• Jaundice
• Hypoglycemia
• Cataract (because of Galactitol - from Galactose 1 phosphate) 

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