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Italian guidelines for the management and treatment of neonatal cholestasis.

Dani C, Pratesi S, Raimondi F, Romagnoli C, Task Force for Hyperbilirubinemia of the Italian Society of Neonatolo - Ital J Pediatr (2015)

Bottom Line: Hyperbilirubinemia is a frequent condition affecting newborns during the first two weeks of life and when it lasts more than 14 days it is defined as prolonged jaundice.This condition requires differential diagnosis between the usually benign unconjugated hyperbilirubinemia and the pathological conjugated hyperbilirubinemia, that is mainly due to neonatal cholestasis.Unfortunately, this does not always occur and, therefore, the Task Force on Hyperbilirubinemia of the Italian Society of Neonatology presents these shared Italian guidelines for the management and treatment of neonatal cholestasis whose overall aim is to provide a useful tool for its assessment for neonatologists and family pediatricians.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Largo Brambilla 3, Florence, 50141, Italy. cdani@unifi.it.

ABSTRACT
Hyperbilirubinemia is a frequent condition affecting newborns during the first two weeks of life and when it lasts more than 14 days it is defined as prolonged jaundice. This condition requires differential diagnosis between the usually benign unconjugated hyperbilirubinemia and the pathological conjugated hyperbilirubinemia, that is mainly due to neonatal cholestasis. It is important that the diagnosis of neonatal cholestasis be well-timed to optimize its management, prevent worsening of the patient's outcome, and to avoid premature, painful, expensive, and useless tests. Unfortunately, this does not always occur and, therefore, the Task Force on Hyperbilirubinemia of the Italian Society of Neonatology presents these shared Italian guidelines for the management and treatment of neonatal cholestasis whose overall aim is to provide a useful tool for its assessment for neonatologists and family pediatricians.

No MeSH data available.


Related in: MedlinePlus

Flow chart for the management of the neonatal cholestasis in term and preterm infants. Modified from ’ with permission
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Fig1: Flow chart for the management of the neonatal cholestasis in term and preterm infants. Modified from ’ with permission

Mentions: The risk of biliary atresia is uncommon in preterm infants so a modified schedule of investigation is appropriate (Fig. 1). Hepatobiliary scintigraphy and liver biopsy should be delayed until the infant’s corrected gestational age is more than one term and his/her weight is more than 2 kg unless there is biliary dilation. Liver biopsy is indicated in the presence of acholic stools, cholestasis which persists beyond a corrected age of 2–3 months, and in patients who have a nonexcreting hepatobiliary scan [2, 4].Fig. 1


Italian guidelines for the management and treatment of neonatal cholestasis.

Dani C, Pratesi S, Raimondi F, Romagnoli C, Task Force for Hyperbilirubinemia of the Italian Society of Neonatolo - Ital J Pediatr (2015)

Flow chart for the management of the neonatal cholestasis in term and preterm infants. Modified from ’ with permission
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4591626&req=5

Fig1: Flow chart for the management of the neonatal cholestasis in term and preterm infants. Modified from ’ with permission
Mentions: The risk of biliary atresia is uncommon in preterm infants so a modified schedule of investigation is appropriate (Fig. 1). Hepatobiliary scintigraphy and liver biopsy should be delayed until the infant’s corrected gestational age is more than one term and his/her weight is more than 2 kg unless there is biliary dilation. Liver biopsy is indicated in the presence of acholic stools, cholestasis which persists beyond a corrected age of 2–3 months, and in patients who have a nonexcreting hepatobiliary scan [2, 4].Fig. 1

Bottom Line: Hyperbilirubinemia is a frequent condition affecting newborns during the first two weeks of life and when it lasts more than 14 days it is defined as prolonged jaundice.This condition requires differential diagnosis between the usually benign unconjugated hyperbilirubinemia and the pathological conjugated hyperbilirubinemia, that is mainly due to neonatal cholestasis.Unfortunately, this does not always occur and, therefore, the Task Force on Hyperbilirubinemia of the Italian Society of Neonatology presents these shared Italian guidelines for the management and treatment of neonatal cholestasis whose overall aim is to provide a useful tool for its assessment for neonatologists and family pediatricians.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Largo Brambilla 3, Florence, 50141, Italy. cdani@unifi.it.

ABSTRACT
Hyperbilirubinemia is a frequent condition affecting newborns during the first two weeks of life and when it lasts more than 14 days it is defined as prolonged jaundice. This condition requires differential diagnosis between the usually benign unconjugated hyperbilirubinemia and the pathological conjugated hyperbilirubinemia, that is mainly due to neonatal cholestasis. It is important that the diagnosis of neonatal cholestasis be well-timed to optimize its management, prevent worsening of the patient's outcome, and to avoid premature, painful, expensive, and useless tests. Unfortunately, this does not always occur and, therefore, the Task Force on Hyperbilirubinemia of the Italian Society of Neonatology presents these shared Italian guidelines for the management and treatment of neonatal cholestasis whose overall aim is to provide a useful tool for its assessment for neonatologists and family pediatricians.

No MeSH data available.


Related in: MedlinePlus