| Prevalence and outcome of hepatobiliary dysfunction in neonatal septicaemia. | |
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MedLine Citation:
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PMID: 21873892 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Cholestatic jaundice and liver enzyme abnormalities have been reported in neonatal septicaemia; the course, pattern, and outcome of such hepatobiliary dysfunction have not been described. METHODS: One hundred fifty-three neonates with blood culture-positive sepsis were recruited from the neonatal intensive care unit of an urban hospital. Liver function tests were done on day 3 and day 10 in all of the cases. In babies with abnormal results (direct bilirubin >20% of total with a minimum level of 2/dL or alanine aminotransferase [ALT] >50 U/L), tests were repeated weekly for 1 month and then fortnightly for 3 months or until normalization of values. Anthropometry was recorded at all of these visits. RESULTS: Klebsiella pneumoniae was the commonest organism, isolated in 95.4% of subjects. Eighty-three (54.2%) subjects had hepatobiliary dysfunction in the form of either cholestatic jaundice (n = 65 [42.5%]) or derangement in ALT (n = 57 [37.3%]). The onset of cholestasis was seen by day 3 of sepsis in 80% (n = 52), with maximum value of direct bilirubin seen by the 10th day in 90% (n = 58). Only 15% (n = 10) continued to have cholestatic jaundice beyond 30 days of onset of sepsis, and it resolved by 60 days. Hepatic enzyme abnormalities followed a more protracted course: onset by day 10 in 95%, peak value by day 38 in 90%, and normalisation by 60 days in 82% of subjects. The prevalence of any hepatobiliary dysfunction was found less frequently in babies who died as compared with survivors (43.4% vs 56.7%; P < 0.01). The weight, length, and head circumference during follow-up visits were comparable between neonates with or without hepatobiliary dysfunction. CONCLUSIONS: Hepatobiliary dysfunction is common in Gram-negative neonatal septicaemia. The onset of abnormalities is early in most cases but ultimately resolve within 2 to 3 months after sepsis. The presence of conjugated hyperbilirubinemia in neonatal sepsis may carry a better prognosis in terms of survival and has no significant effect on growth during early infancy. |
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Authors:
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Sumaira Khalil; Dheeraj Shah; M M A Faridi; Ashwani Kumar; Kiran Mishra |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of pediatric gastroenterology and nutrition Volume: 54 ISSN: 1536-4801 ISO Abbreviation: J. Pediatr. Gastroenterol. Nutr. Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-01-23 Completed Date: 2012-09-04 Revised Date: 2013-01-14 |
Medline Journal Info:
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Nlm Unique ID: 8211545 Medline TA: J Pediatr Gastroenterol Nutr Country: United States |
Other Details:
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Languages: eng Pagination: 218-22 Citation Subset: IM |
Affiliation:
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Department of Paediatrics, University College of Medical Sciences, University of Delhi and GTB Hospital, Delhi, India. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Alanine Transaminase
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blood Bacteremia / blood, complications*, mortality Biological Markers / blood Cholestasis / blood, epidemiology, microbiology*, mortality Follow-Up Studies Humans Infant, Newborn Jaundice, Obstructive / blood, epidemiology, microbiology*, mortality Klebsiella Infections / blood, complications*, mortality Klebsiella pneumoniae / isolation & purification Liver Function Tests Prevalence Prognosis Prospective Studies |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; EC 2.6.1.2/Alanine Transaminase |
| Comments/Corrections | |
Comment In:
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J Pediatr Gastroenterol Nutr. 2012 Dec;55(6):e153; author reply e153
[PMID:
22986371
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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