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A Common Clinical Challenge: Neonatal Jaundice Is it Physiologic or Pathologic?

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Presentation on theme: "A Common Clinical Challenge: Neonatal Jaundice Is it Physiologic or Pathologic?"— Presentation transcript:

1 Pediatric Cholestatic Jaundice: Differential Diagnosis of Treatable Disorders

2 A Common Clinical Challenge: Neonatal Jaundice Is it Physiologic or Pathologic?

3 Case: Full-Term Female Infant

4 Neonatal Jaundice

5 Neonatal Jaundice (cont)

6 Case (cont) Recurrence of Jaundice After Initial Improvement

7 Case (cont) Diagnosis: Prolonged Neonatal Jaundice

8 Prolonged Neonatal Jaundice Breast Milk-Related Jaundice

9 Prolonged Neonatal Jaundice: Is It Noncholestatic or Cholestatic in Origin?

10 Liver Disease in the Newborn

11 Differential Diagnosis of Cholestasis in Newborns Think Anatomic

12 Differential Diagnosis of Cholestasis in Newborns (cont)

13 Evaluating Prolonged Neonatal Jaundice Visual Assessment is Observer Dependent

14 NASPGHAN/ESPGHAN: Recommendations for Evaluation of the Potential for Cholestatic Liver Diseases

15 Evaluation of the Baby With Persistent Jaundice

16 Evaluation of the Baby With Persistent Jaundice (cont)

17 Physical Examination of the Baby With Persistent Jaundice: Head to Toe

18 Physical Examination of the Baby With Persistent Jaundice: Head to Toe (cont)

19 Evaluation of the Baby With Persistent Jaundice Additional Laboratory Tests

20 Evaluation of the Baby With Persistent Jaundice Additional Laboratory Tests (cont)

21 Differential Diagnosis: Intrahepatic Cholestasis Red Flags That Require Early Intervention

22 Differential Diagnosis of Treatable Disorders: Single-Gene Defects Identification and Early Intervention Can Make a Difference

23 Origins of Neonatal Cholestasis

24 Emory Cholestasis 57 Gene Panel
Emory Cholestasis 57 Gene Panel* Only 1 Blood Sample Required to Identify Key Genes: Example of a Gene Panel

25 NASPGHAN/ESPGHAN Recommendations

26 NASPGHAN/ESPGHAN Recommendations (cont)

27 NASPGHAN/ESPGHAN Recommendations (cont)

28 NASPGHAN/ESPGHAN Recommendation Consider Whether a Liver Biopsy Would Be Helpful

29 Liver Biopsy for Biliary Atresia Does the Patient Need An Intraoperative Cholangiogram?

30 Biliary Atresia

31 Therapies Are Available for Some Cholestatic Disorders

32 Concluding Remarks Take-Home Messages

33 Abbreviations

34 Abbreviations (cont)


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