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Pediatric cholestasis

Danielle Usatin, Melissa Fernandes, Isabel E Allen, Emily R Perito, James Ostroff, Melvin B Heyman
OBJECTIVES: To systematically review risks and summarize reported complication rates associated with the performance of endoscopic retrograde cholangiopancreatography (ERCP) in children during the past 2 decades. STUDY DESIGN: A systematic literature search of MEDLINE, Embase, and Web of Science from January 1995 to January 2016 was conducted for observational studies published in English. Studies reporting ERCP complications in patients <21 years without history of liver transplant or cholecystectomy were included...
September 20, 2016: Journal of Pediatrics
Carlo Caffarelli, Francesca Santamaria, Dora Di Mauro, Carla Mastrorilli, Virginia Mirra, Sergio Bernasconi
This review focuses key advances in different pediatric fields that were published in Italian Journal of Pediatrics and in international journals in 2015. Weaning studies continue to show promise for preventing food allergy. New diagnostic tools are available for identifying the allergic origin of allergic-like symptoms. Advances have been reported in obesity, short stature and autoimmune endocrine disorders. New molecules are offered to reduce weight gain and insulin-resistance in obese children. Regional investigations may provide suggestions for preventing short stature...
August 27, 2016: Italian Journal of Pediatrics
Prathima Nandivada, Meredith A Baker, Paul D Mitchell, Alison A O'Loughlin, Alexis K Potemkin, Lorenzo Anez-Bustillos, Sarah J Carlson, Duy T Dao, Gillian L Fell, Kathleen M Gura, Mark Puder
BACKGROUND: Parenteral fish-oil (FO) therapy is a safe and effective treatment for intestinal failure-associated liver disease (IFALD). Patients whose cholestasis does not resolve with FO may progress to end-stage liver disease. OBJECTIVE: We sought to identify factors associated with the failure of FO therapy in treating IFALD to guide prognostication and referral guidelines. DESIGN: Prospectively collected data for patients treated with FO at Boston Children's Hospital from 2004 to 2014 were retrospectively reviewed...
September 2016: American Journal of Clinical Nutrition
Rima Fawaz, Ulrich Baumann, Udeme Ekong, Björn Fischler, Nedim Hadzic, Cara L Mack, Valérie A McLin, Jean P Molleston, Ezequiel Neimark, Vicky Lee Ng, Saul J Karpen
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 (BA, 25-40%) followed by an expanding list of monogenic disorders (25%), plus many unknown or multifactorial (e...
July 16, 2016: Journal of Pediatric Gastroenterology and Nutrition
Wei-Xia Lin, Han-Shi Zeng, Zhan-Hui Zhang, Man Mao, Qi-Qi Zheng, Shu-Tao Zhao, Ying Cheng, Feng-Ping Chen, Wang-Rong Wen, Yuan-Zong Song
Citrin deficiency (CD) is a Mendelian disease due to biallelic mutations of SLC25A13 gene. Neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) is the major pediatric CD phenotype, and its definite diagnosis relies on SLC25A13 genetic analysis. China is a vast country with a huge population, but the SLC25A13 genotypic features of CD patients in our country remains far from being well clarified. Via sophisticated molecular analysis, this study diagnosed 154 new CD patients in mainland China and identified 9 novel deleterious SLC25A13 mutations, i...
2016: Scientific Reports
M L Gao, X M Zhong, X Ma, H J Ning, D Zhu, J Z Zou
OBJECTIVE: To make genetic diagnosis of Alagille syndrome (ALGS) patients using target gene sequence capture and next generation sequencing technology. METHOD: Target gene sequence capture and next generation sequencing were used to detect ALGS gene of 4 patients. They were hospitalized at the Affiliated Hospital, Capital Institute of Pediatrics between January 2014 and December 2015, referred to clinical diagnosis of ALGS typical and atypical respectively in 2 cases...
June 2, 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Dilek Yılmaz-Çiftdoğan, Engin Köse, Selda Aslan, Efgan Gayyurhan
Hepatitis A virus (HAV) infection has several atypical manifestations, including fulminant hepatitis, relapsing hepatitis, prolonged cholestasis and extrahepatic manifestations. In this study, we aimed to describe the characteristics and outcomes of the pediatric patients with atypical manifestations of HAV infection. Four hundred twelve children with symptomatic hepatitis A infection admitted to Gaziantep Children's Hospital Department of Pediatric Infectious Disease between August 2011 and January 2013 were analyzed retrospectively...
July 2015: Turkish Journal of Pediatrics
Joseph Philip, Ravi S Samraj, Dalia Lopez-Colon, Regino Gonzalez-Peralta, Arun Chandran, Mark S Bleiwies
Adult literature documents increased cholestasis in right heart failure yet is poorly documented in the pediatric population. We describe three infants with congenital heart disease who developed significantly elevated direct bilirubin levels of 43, 23, and 12 mg/dL, respectively, in the absence of hepatic dysfunction. The common hemodynamic pathophysiology in these infants is right heart dysfunction with moderate to severe tricuspid regurgitation in the setting of low perfusion state. Right heart dysfunction in infants can result in severe conjugated bilirubin, likely as a consequence of venous congestion and can be used as an indirect marker of right heart dynamics...
May 6, 2016: World Journal for Pediatric & Congenital Heart Surgery
Mehmet Hanifi Okur, Yücel Yankol, Nesimi Mecit, Gültekin Hoş, Gökhan Ertugrul, Turan Kanmaz, Koray Acarli, Münci Kalayoglu
OBJECTIVES: Diaphragmatic hernia is a rare complication after pediatric liver transplant. This report presents occurrences of diaphragmatic hernia after living-donor liver transplants in 2 children. MATERIALS AND METHODS: In 1 of the 2 patients, a right-sided diaphragmatic hernia developed after a living-donor liver transplant due to progressive familial intrahepatic cholestasis where a left lateral segment graft was used. In the other patient, a left-sided diaphragmatic hernia developed after a living-donor liver transplant due to biliary atresia following Kasai portoenterostomy where a left lateral segment graft was used...
April 20, 2016: Experimental and Clinical Transplantation
Aya M Fattouh, Engy A Mogahed, Nehal Abdel Hamid, Rodina Sobhy, Noha Saber, Hanaa El-Karaksy
BACKGROUND: There is deficiency of data about congenital heart defects (CHDs) in cholestatic disorders of infancy other than Alagille syndrome (AGS). We aimed to define the prevalence and types of CHDs in infants with various causes of cholestatic disorders of infancy. METHODS: This cross-sectional study was conducted on 139 infants presenting with cholestasis whether surgical or non-surgical. The study was carried out at the Pediatric Hepatology Unit, Cairo University Children's Hospital, Egypt...
September 2016: Archives of Disease in Childhood
Racha Khalaf, Claudia Phen, Sara Karjoo, Michael Wilsey
Cholestasis results from impairment in the excretion of bile, which may be due to mechanical obstruction of bile flow or impairment of excretion of bile components into the bile canaliculus. When present, cholestasis warrants prompt diagnosis and treatment. The differential diagnosis of cholestasis beyond the neonatal period is broad and includes congenital and acquired etiologies. It is imperative that the clinician differentiates between intrahepatic and extrahepatic origin of cholestasis. Treatment may be supportive or curative and depends on the etiology...
March 2016: Pediatric Gastroenterology, Hepatology & Nutrition
Dawei Li, Tianfei Lu, Conghuan Shen, Yuan Liu, Jiang Zhang, Yuhua Shan, Yi Luo, Zhifeng Xi, Bijun Qiu, Qimin Chen, Jianjun Zhang, Qiang Xia
Fibroblast growth factor 21 is a critical circulating adipokine involving in metabolic disorders and various liver diseases. This study was performed to investigate whether FGF21 is also associated with the pathophysiology of biliary atresia. Serum FGF21 levels were measured in 57 BA patients and 20 age matched healthy controls. We also examined hepatic FGF21 mRNA expression and FGF21 protein levels in liver tissues obtained from 15 BA patients undergoing liver transplantation and 5 cases of pediatric donation after cardiac death donor without liver diseases by RT-PCR and Western blotting...
July 2016: Cytokine
Xiangwei Hua, Tianfei Lu, Jiang Zhang, Qi Miao, Zhaolian Bian, Haiyan Zhang, Shanshan Huang, Weiwei Lin, Zhifeng Xi, Ming Zhang, Qimin Chen, Xiong Ma, Jianjun Zhang, Qiang Xia
AIM: Hypoxia-inducible factor-2alpha(HIF-2α) has been reported to play an important role in a host of pathophysiological processes including cellular survival. The current work is to explore the role of HIF-2α in cholestasis-mediated hepatocyte apoptosis. METHODS: HIF-2α expression was measured by immunohistochemistry and confocal microscopy. Hepatic apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP-digoxigenin nick-end labeling (TUNEL)...
March 18, 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Marcelo Rodríguez, Jose Moreno, Rolando Márquez, Ricardo Eltit, Felipe Martinez, Alvaro Sepúlveda-Martínez, Mauro Parra-Cordero
OBJECTIVE: To evaluate the fetal mechanical PR interval in fetuses from pregnancies with intrahepatic cholestasis of pregnancy (ICP). METHODS: A case-control study was conducted in the Maternal-Fetal Medicine Unit at Hospital Carlos Van Buren between 2011 and 2013. Fetal echocardiography was performed in patients with ICP and normal pregnancies. Demographic and clinical characteristics were compared using the Mann-Whitney U test for continuous variables. A p value <0...
March 10, 2016: Fetal Diagnosis and Therapy
Imeke Goldschmidt, Thomas Thum, Ulrich Baumann
Circulating microRNAs have been investigated as markers of disease severity in a variety of conditions. We examined whether circulating miR-21 and miR-29a could serve as markers of hepatic fibrosis and disease etiology in children with various liver diseases. Circulating miR-21 and miR-29a were determined in 58 children (21 female, age 0.1-17.8 (median 9.8) years)) with chronic liver disease and compared to histological grading of hepatic fibrosis. 22 healthy children served as controls for circulating miRNAs...
2016: Journal of Clinical Medicine
Sudhamshu Kc, Dilip Sharma, Nandu Poudyal, Bhupendra Kumar Basnet
INTRODUCTION: Our clinical experience showed that there has been no decrease in pediatric cases of acute viral hepatitis in Kathmandu. The objective of the study was to analyze the etiology, clinical features, laboratory parameters, sonological findings and other to determine the probable prognostic factors of Acute Viral Hepatitis in pediatric population. METHODS: Consecutive patients of suspected Acute Viral Hepatitis, below the age of 15 years, attending the liver clinic between January 2006 and December 2010 were studied...
January 2014: JNMA; Journal of the Nepal Medical Association
Zahida Khan, Veena L Venkat, Kyle A Soltys, Donna B Stolz, Sarangarajan Ranganathan
Jaundice in the newborn period can be physiologic and is often due to benign causes. Jaundice due to conjugated hyperbilirubinemia extending beyond the second week of life may be an early sign of several cholestatic or metabolic liver diseases, and it requires logical and timely analysis so that specific treatments can be initiated. A1AT deficiency is the most common genetic cause of pediatric liver disease and transplantation, and it must be considered when evaluating cholestatic infants. Here, we present an unusual case of A1AT deficiency with severe infantile cholestasis and rapid decompensation in the first 4 months of life, where in-depth but timely diagnosis was crucial for the appropriate intervention to take place...
February 8, 2016: Pediatric and Developmental Pathology
Mehmet Ağın, Gökhan Tümgör, Murat Alkan, Önder Özden, Mehmet Satar, Recep Tuncer
BACKGROUND/AIMS: The purpose of this study was to identify important clues in differentiating biliary atresia (BA) from causes of neonatal cholestasis other than BA (non-BA) and establishing the reliability of current tests. MATERIALS AND METHODS: Thirty-four patients with BA and 27 patients with non-BA cholestasis being monitored at the Çukurova University Medical Faculty, the Pediatric Gastroenterology Department and the Pediatric Surgery Department between 2009 and 2015 were retrospectively assessed...
January 2016: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Giuseppe Orso, Claudia Mandato, Claudio Veropalumbo, Nicola Cecchi, Alfredo Garzi, Pietro Vajro
Parenteral nutrition constitutes a life-saving therapeutic tool in patients unable to ingest/absorb oral or enteral delivered nutrients. Liver function tests abnormalities are a common therapy-related complication, thus configuring the so-called Parenteral Nutrition Associated Liver Disease (PNALD) or cholestasis (PNAC). Although the damage is frequently mild, and resolves after discontinuation of parenteral nutrition, in some cases it progresses into cirrhotic changes, especially in neonates and infants. We present a literature review focusing on the pathogenetic mechanisms-driven prevention and therapies for the cases where parenteral nutrition cannot be discontinued...
March 2016: Digestive and Liver Disease
Qiao-Qun Ou, Xin-Hua Qian, Ding-You Li, You-Xiang Zhang, Xia-Nan Pei, Jin-Wen Chen, Li Yu
BACKGROUND: The treatment of intrahepatic cholestasis has been limited, and development of an effective drug is needed. Clinical studies have shown that Yinzhihuang (YZH), a traditional Chinese decoction, enhances bilirubin clearance. The goal of this study was to determine the protective effect of YZH on experimental intrahepatic cholestasis in young rats and to explore its underlying molecular mechanisms. METHODS: Intrahepatic cholestasis in rats was induced by α-naphthylisothiocyanate (ANIT) on days 1 and 8...
April 2016: Pediatric Research
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