UNIGE document Scientific Article
previous document  unige:96670  next document
add to browser collection
Title

Guideline for the evaluation of cholestatic jaundice in infants

Authors
Fawaz, Rima
Baumann, Ulrich
Ekong, Udeme
Fischler, Björn
Hadzic, Nedim
Mack, Cara L
Molleston, Jean P
show hidden authors show all authors [1 - 11]
Published in Journal of Pediatric Gastroenterology and Nutrition. 2017, vol. 64, no. 1, p. 154-168
Abstract Cholestatic jaundice in infancy affects approximately 1 in every 2500 term infants and is infrequently recognized by primary providers in the setting of physiologic jaundice. Cholestatic jaundice is always pathologic and indicates hepatobiliary dysfunction. Early detection by the primary care physician and timely referrals to the pediatric gastroenterologist/hepatologist are important contributors to optimal treatment and prognosis. The most common causes of cholestatic jaundice in the first months of life are biliary atresia (25%-40%) followed by an expanding list of monogenic disorders (25%), along with many unknown or multifactorial (eg, parenteral nutrition-related) causes, each of which may have time-sensitive and distinct treatment plans. Thus, these guidelines can have an essential role for the evaluation of neonatal cholestasis to optimize care. The recommendations from this clinical practice guideline are based upon review and analysis of published literature and the combined experience of the authors. The committee recommends that any infant noted to be jaundiced after 2 weeks of age be evaluated for cholestasis with measurement of total and direct serum bilirubin, and that an elevated serum direct bilirubin level (direct bilirubin levels >1.0 mg/dL or >17 μmol/L) warrants timely consideration for evaluation and referral to a pediatric gastroenterologist or hepatologist. Of note, current differential diagnostic plans now incorporate consideration of modern broad-based next-generation DNA sequencing technologies in the proper clinical context. These recommendations are a general guideline and are not intended as a substitute for clinical judgment or as a protocol for the care of all infants with cholestasis. Broad implementation of these recommendations is expected to reduce the time to the diagnosis of pediatric liver diseases, including biliary atresia, leading to improved outcomes.
Identifiers
PMID: 27429428
Note Sous-titre : Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
Full text
Article (Published version) (397 Kb) - document accessible for UNIGE members only Limited access to UNIGE
Structures
Research group Développement du tube digestif chez les vertébrés (900)
Citation
(ISO format)
FAWAZ, Rima et al. Guideline for the evaluation of cholestatic jaundice in infants. In: Journal of Pediatric Gastroenterology and Nutrition, 2017, vol. 64, n° 1, p. 154-168. https://archive-ouverte.unige.ch/unige:96670

52 hits

0 download

Update

Deposited on : 2017-09-13

Export document
Format :
Citation style :