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Thirty-five cases of neonatal hepatitis (20 males and 15 females) were reviewed, 3
of whom were lost during the follow-up, leaving 32 patients for review. There were
10 late deaths and 22 patients survived, 18 of whom with a normal bilirubin level
and 4 with a bilirubin level of >1.0 mg/dL. In the 18, jaundice disappeared between
the ages of 4 and 7 months. The current lifestyles of the patients include 4 adults
aged 19 to 21 who are either working or at university, while the other 18 children
are all making good progress at school. Except for moderate growth retardation in
3 children, all are growing well. In all 10 patients who died, liver failure persisted
until the time of death. Three died of other causes and 7 died of neonatal hepatitis
itself between 4 months and 7 years of age. Four patients ran a fulminating course
resulting in death between the ages of 4 and 12 months. All 7 had growth and developmental
retardation. A histological examination showed that in those who died, there was significantly
more periportal fibrosis, inflammation in the periportal area, and diffuse giant cell
transformation. These results indicate that some infants with neonatal hepatitis have
a poor prognosis and, therefore, the identification of such a condition requires a
careful, long-term follow-up.
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References
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Footnotes
*Presented at the 24th Annual Meeting of the Pacific Association of Pediatric Surgeons, Hong Kong, May 20–24, 1991.
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Copyright
© 1992 W.B. Saunders Company. All right reserved. Published by Elsevier Inc.