Document Detail

Liver fibrosis in an extremely small infant for gestational age.
MedLine Citation:
PMID:  20513975     Owner:  NLM     Status:  MEDLINE    
Premature infants with intrauterine growth restriction (IUGR) are at greater risk for an adverse perinatal outcome. IUGR affects hepatocyte function, but the histopathological changes in the postnatal liver are not well known. We report a male infant with severe IUGR. His mother was transferred to our hospital at 26 weeks of gestation because of preterm labor and severe IUGR. An emergency cesarean section was carried out because of a non-reassuring fetal status. The birth weight of the infant was 332 g. He showed congestive heart failure and marked hepatomegaly from birth. After 1 week, blood examinations showed hyperbilirubinemia with high direct bilirubin. Because of liver dysfunction, he received the minimal total parenteral nutrition for 7 days. After 1 month, he progressively developed ascites and coagulopathy, and died 3 months after birth. Liver autopsy showed diffuse perisinusoidal fibrosis. Fibrosis was also prominent around the central vein. Immunohistochemical study revealed many alpha-smooth muscle actin-positive cells, which represent activated hepatic stellate cells, and a few transforming growth factor-beta1-positive cells in the perisinusoidal fibrotic area. These results indicate that the infant developed chronic (end stage) liver failure by 3 months of age. We excluded congenital infection, metabolic syndrome and citrin deficiency. It is therefore conceivable that intrauterine cardiac failure may be responsible for liver fibrosis. Early detection of liver dysfunction soon after birth is a key to predict the prognosis of severe IUGR in preterm infants.
Hirokazu Arai; Atsuko Noguchi; Ryoji Goto; Takefumi Matsuda; Hatsushi Nakajima; Tsutomu Takahashi
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Tohoku journal of experimental medicine     Volume:  221     ISSN:  1349-3329     ISO Abbreviation:  Tohoku J. Exp. Med.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-01     Completed Date:  2010-09-30     Revised Date:  2013-01-03    
Medline Journal Info:
Nlm Unique ID:  0417355     Medline TA:  Tohoku J Exp Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  181-5     Citation Subset:  IM    
Department of Pediatrics, Akita University Graduate School of Medicine, Akita, Japan.
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MeSH Terms
Fatal Outcome
Hyperbilirubinemia / blood
Infant, Extremely Low Birth Weight* / blood
Infant, Newborn
Infant, Premature, Diseases / blood,  physiopathology*,  ultrasonography
Infant, Small for Gestational Age* / blood
Liver / pathology
Liver Cirrhosis / blood,  congenital*,  physiopathology*,  ultrasonography
Ultrasonography, Prenatal

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