Etiology of 142 cases of infant cholestasis and the evaluation of the common diagnostic methods

Abstract：Objective To investigate the etiology of infant cholestasis, and to evaluate the commonly clinical diagnostic methods in diagnosing infant biliary atresia (BA). Methods A total of 142 hospitalized children with infant cholestasis in the pediatric ward of our hospital from January 1, 2012 to November 30, 2016 were included. Results Totally 99 cases (69.7％) were comfirmed, and the most common causes were BA, cytomegalovirus infection and citrin protein deficiency.Totally 37 cases (26.1％) were diagnosed as idiopathic infant hepatitis and 6 cases (4.2％) were undiagnosed. Compared with no-BA group, acholie stools predominated in BA group, and the serum γ-GT in BA were significantly higher. Abdominal ultrasonography showed that 81.2％ were cholecyst undiscovered or small in size in BA. Hepatobiliary scintigraphy (HBS) showed that 95.0％ had no image of gallbladder or radioactive concentration in bowel and 5.0％ had delayed image or radioactive conceatration in BA. The difference between the two group;was statistical (P＜0.01). The sensitivity, specificity, and accuracy of acholic stools to diagnose BAwere 91.3％, 92.9％, and 92.2％, γ-GT≥300 U/Lwere 65.2％, 91.8％, 83.3％, abdominal ultrasonography were 68.8％, 90.8％, 84.9％, HBS were 95％, 50％, 68.0％, respectively. Conclusion The common causes of infant cholestasis in BA, idiopathic hepatitis, cytomegalovirus infection, and Citrin protein deficiency. In the infant cholestasis with acholic stools, infracostal liver≥3 cm, serum γ-GT≥300 U/L, cholecyst undiscovered or small in size in abdominal ultrasonography, HBS undiscovered or delayed image of gallbladder or radioactive concentration in bowel, the BA should be suspected.