Idiopathic neonatal hepatitis presenting as neonatal hepatic siderosis and steatosis

Idiopathic neonatal hepatitis (INH) is a heterogeneous disease of undetermined cause. We report a retrospective histologic reevaluation of INH. Sixty patients with INH were reviewed along with 32 biliary atresia (BA) patients. Histologic findings, iron and fat deposits, giant cell transformation, po...

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Bibliographic Details
Published in:Digestive diseases and sciences 1998-02, Vol.43 (2), p.392-396
Main Authors: TAZAWA, Y, ABUKAWA, D, MAISAWA, S, NISHINOMIYA, F, OYAKE, Y, TAKADA, G, KONNO, T
Format: Article
Language:English
Subjects:
Biliary Atresia - pathology
Biological and medical sciences
Fat Necrosis - pathology
Gastroenterology. Liver. Pancreas. Abdomen
Hemosiderosis - pathology
Hepatitis - pathology
Humans
Infant
Liver - pathology
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Medical sciences
Other diseases. Semiology
Retrospective Studies
Siderosis - pathology
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Summary:Idiopathic neonatal hepatitis (INH) is a heterogeneous disease of undetermined cause. We report a retrospective histologic reevaluation of INH. Sixty patients with INH were reviewed along with 32 biliary atresia (BA) patients. Histologic findings, iron and fat deposits, giant cell transformation, portal fibrosis, and bile duct proliferation were semiquantitatively graded from 0 to 4+. Significant histologic findings were defined as > or =2+. Frequencies of patients with significant histologic findings in the INH group were compared with those of the BA group. Among the patients with significant histologic findings, those in the INH group had significantly less iron deposits (P < 0.01), portal fibrosis (P < 0.01), and bile duct proliferation (P < 0.01) than those of the BA group. A combination of significant hepatic macrovesicular steatosis and siderosis was observed in 10 INH patients but not in any BA patient (10/60 vs 0/32, P < 0.05). Without extensive treatment, the 10 INH patients all recovered, and hepatic abnormalities normalized by the age of 12 months. In conclusion, the present study showed that the recognition of hepatic siderosis is helpful to distinguish BA from INH and that in a subset of INH patients hepatic macrovesicular steatosis and siderosis occurs.
ISSN:0163-2116
1573-2568
DOI:10.1023/A:1018827027033