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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

After analysis of 33 cases of neonatal hepatitis and 90 cases of biliary atresia, a score test from history, physical findings and daily laboratory examinations was studied for the differential diagnosis of these two diseases. The biliary atresia takes plus score, whereas the neonatal hepatitis takes minus score. The score test is of great value for the differential diagnosis between these two diseases.
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PMID:Differentiation of biliary atresia from neonatal hepatitis by routine clinical examinations. 4 41

It is proposed that some cases of biliary atresia and neonatal hepatitis may be initiated by an adverse effect of unsaturated monohydroxy bile acids on the fetal and infantile hepatobiliary system. The hypothesis is founded on morphological observations in patients with biliary atresia and on the toxic effects of monohydroxy bile acids on the hepatobiliary system.
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PMID:Unsaturated monohydroxy bile acids as a cause of idiopathic obstructive cholangiopathy. 5 56

Serum alpha-fetoprotein levels were measured using a sensitive radioimmunoassay in 77 infants presenting with persistent conjugated hyperbilirubinaemia. A breed range of alpha-fetoprotein concentrations occurred in both the 23 infants with extrahepatic biliary atresia and the 35 with idiopathic neonatal hepatitis but the 13 with alpha-1-antitrypsin deficiency had uniformly low levels. High alpha-fetoprotein concentrations (above 10 000 mug/1) favoured the diagnosis of neonatal hepatitis especially in the first ten weeks of life, but the overlap between neonatal hepatitis and extrahepatic biliary atresia was large and alpha-fetoprotein determination cannot be recommended as a reliable method for distinguishing the two conditions. Serial alpha-fetoprotein values showed no consistent relationship with standard liver function tests and gave no guide to prognosis. There was an association between alpha-fetoprotein production and needle biopsy evidence of hepatic giant cell transformation. The uniformly low alpha-fetoprotein levels in alpha-1-antitrypsin deficient infants with neonatal hepatitis is a new observation and possible mechanisms for disordered glycoprotein release are discussed.
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PMID:Serum alpha-fetoprotein levels in extrahepatic biliary atresia, idiopathic neonatal hepatitis and alpha-1-antitrypsin deficiency (PiZ). 6 Aug 72

It has been suggested that the quantitative estimation of serum alpha-1-fetoprotein may help in distinguishing the neonatal hepatitis syndrome from biliary atresia. We measured the serum AFP concentration in 52 neonates and infants with various hepatobiliary disorders, including neonatal hepatitis syndrome (group I), biliary atresia (group II), and other hepatopathies such as choledochal cyst (group III). The mean serum AFP concentration in patients with neonatal hepatitis was significantly greater than the mean concentration in the other two groups. There was no significant difference between the mean serum AFP concentrations in patients with biliary atresia and in group III patients. Patient age was noted to be an important factor: Serum AFP levels greater than 35 microgram/ml in infants one to four months of age suggpst the diagnosis of neonatal hepatitis syndrome. Serum AFP levels below 10 microgram/ml in infants less than four months of age suggest the diagnosis of biliary atresia or hepatopathies other than neonatal hepatitis. However, the variable and significant overlapping of serum AFP values between 10 and 35 microgram/ml limit the diagnostic value of this test.
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PMID:Alpha1-fetoprotein in neonatal hepatobiliary disease. 6 21

The diagnostic value of laboratory and scintigraphic examination techniques in young infants with cholestatic jaundice will be discussed. The correct diagnosis of neonatal hepatitis or extrahepatic biliary atresia cannot be derived from such investigations as determination of bilirubin, enzyme activities, immunologic or serologic parameters or scintigraphy of the liver. Only quantitative changes of serum LP-X before and after administration of cholestyramin and the modified rose-bengal test may help to establish a correct diagnosis in cholestatic jaundice during the first 6 weeks of life.
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PMID:[Diagnostic value of laboratory and scintigraphic investigations in young infants with cholestatic jaundice (author's transl)]. 8 97

During the 11 1/2 year period ending 13 months ago, 93 consecutive patients were treated with orthotopic liver transplantation. Fifty-six of the recipients were 18 years old or younger, and the other 37 were adults. The most common indications for operation were biliary atresia, primary hepatic malignant tumor, chronic aggressive hepatitis and alcoholic cirrhosis. There has been a gradual improvement in results throughout the period of study, although to a satisfactory level. Twenty-seven of the 93 patients survived for at least one year after liver replacement with a maximum of six years, and 16 are still alive after 13 to 71 months. The 11 late deaths after one to six years were caused by chronic rejection, biliary obstruction, recurrence of hepatoma, systemic infection or hepatitis of the homograft. Rejection of the liver as judged by classical histopathologic criteria played a surprisingly small role in the heavy over-all mortality, accounting for less than 10 per cent of the deaths. Technical or mechanical problems, especially those of biliary duct reconstruction, were a far greater cause of failure, as were systemic infections. Six of the 37 adult recipients had lethal cerebrovascular accidents during, or just after, operation. When abnormalities of liver function developed in the postoperative period, the nearly automatic diagnosis of homograft rejection, in retrospect, proved to have been wrong in most instances. Further development of liver transplantation depends upon two kinds of progress. There must be reduction of operative and early postoperative accidents and complications by more discriminating patient selection, purely technical improvement and better standardization of biliary duct reconstruction. The second area will be in sharpening the criteria for the differnetial diagnosis of postoperative hepatic malfunction, including the liberal use of transhepatic cholangiography and needle biopsy. Only then can better decisions be made about changes in medication or about the need for secondary corrective surgical procedures.
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PMID:Orthotopic liver transplantation in ninety-three patients. 17 41

Whether a patient develops the HBsAg carrier state may depend on his genome. HBsAg subtypes may reflect the viral genome and may be of prognostic significance. Different subtypes predominate in different populations throughout the world. Altered immune response, as in patients with Down's syndrome, may increase the HBsAg carrier rate. Autoantibodies have been used to differentiate various types of hepatitis. There is an increased incidence of histocompatibility antigen HL-A1 and HL-A8 in patients who have chronic aggressive hepatitis. In primary hepatic carcinoma, the HBsAg carrier rate is increased. Because of the suggestion that neonatal hepatitis, biliary atresia and choledochal cyst may all result from infantile obstructive cholangiopathy, with the precise outcome depending on whether other conditions such as alpha 1-antitrypsin deficiency are also present, we have determined HBsAg in 166 children with a variety of diseases, among them Reye's syndrome, alpha 1-antitrypsin deficiency, and renal disorders. The HBsAg carrier rate in the sera of these patients was normal.
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PMID:Genetic factors and autoimmunity in viral hepatitis. 21 41

Lipoprotein-X (LP-X) in the serum of infants with persistent jaundice is indicative of cholestasis. In early infancy biliary atresia and biliary agenesis are the most common cause of cholestasis, whereas neonatal hepatitis is a less frequent cause of cholestasis. The authors introduced and described the qualitative and quantitative methods of LP-X determination for diagnostic purposes. LP-X estimations were carried out in 9 children with persistent jaundice. LP-X was found to be present in 4 infants-in 2 with complete absence of extrahepatic biliary tracts, in 1 with extrahepatic biliary atresia and in 1 with hypoplastic extrahepatic biliary tract. LP-X was also found in a 5 year old boy with mechanical occlusion of bile ducts caused by a malignant tumor ( rhabdomyoblastoma ), and in 3 year old girl with inborn enzymatic liver dysfunction. In this case LP-X concentration was estimated before and after 3 week course of cholestyramine, after which there was a 35% decrease in the LP-X concentration. In a 4 month old child LP-X was not found in spite of the absence of extra and intrahepatic biliary tracts. This finding may be explained by the far advanced hepatic cirrhosis. The authors stress the importance of introducing of LP-X estimation in the differential diagnosis of jaundice in early infancy.
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PMID:[Lipoprotein X (LP-X) in the differential diagnosis of cholestasis in children, with special reference to biliary atresia]. 26 31

The mean plasma levels of 25-hydroxyvitamin D (25-OH-D) were measured before and after the administration of 2000 units of daily oral vitamin D2 for a period of 2 weeks in 9 normal infants and children, 7 infants with neonatal hepatitis and persistent neonatal hepatitis, and 4 infants with congenital biliary atresia. The mean plasma level of 25-OH-D increased significantly from 19.5 +/- 3.7 (S.E.) ng/ml to 34.0 +/- 6.8 (S.E.) ng/ml after administration of vitamin D2 in controls (p less than 0.05). The mean plasma level of 25-OH-D also increased from 8.0 +/- 2.1 (S.E.) ng/ml to 22.1 +/- 2.6 (S.E.) ng/ml after vitamin D treatment in hepatitis group (p less than 0.05). In patients with congenital biliary atresia, vitamin D treatment did not affect eh plasma levels of 25-OH-D.
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PMID:The plasma levels of 25-hydroxyvitamin D in patients with various liver diseases and the response of 25-hydroxyvitamin D to vitamin D treatment. 30 85

From March 1963 through June 1976, 111 patients received orthotopic liver homografts. Forty-two of the recipients had congenital biliary atresia. Other common diagnoses were chronic aggressive hepatitis, Laennec's cirrhosis, and primary hepatic malignancy. There were also other assorted, less common diagnoses. Thirty-one of the 111 patients (28%) lived at least one year and 15 are still alive with follow-ups of 2 1/2 to 8 1/2 years. Seven of the patients lived for more than five years, and 6 of these 7 are still alive. In 1975 and 1976, clinical-pathologic correlations on all these patients were carried out with Professor K.A. Porter of London. The most common causes for failure were technical misadventures, including biliary tract problems, vascular thromboses, and the use of ischemically damaged livers. Rejection was less of a problem than had been realized. In view of these findings, improvements in intraoperative and postoperative management were made with particular reference to biliary tract drainage and to the use of microvascular techniques. Treatment of a new series of 30 patients was begun in July 1976, and completed in December 1977. After 6 to 22 months, 15 of the 30 most recently treated patients are alive, all living outside the hospital. Thus, the outlook after transplantation appears to have greatly improved, and a one-year survival rate of 50% is projected.
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PMID:Liver transplantation. 35 95


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