790 Clinical and Laboratory Parameters of Neonatal Cholestasis: A Retrospective Study in Dr. Soetomo Hospital Surabaya

Abstract

Background: Early diagnosis of neonatal cholestasis is important for proper management. Making the differential diagnosis of extrahepatic from intrahepatic cholestasis as the first step for diagnosis is also crucial for better prognosis. Objective: To find out differences of clinical and laboratory parameters of patients with intrahepatic and extrahepatic neonatal cholestasis. Method: A retrospective study in infants with neonatal cholestasis who admitted to department of pediatric dr. Soetomo Hospital since 1999 to 2009 was done. Clinical findings (age, gender, birth weight, jaundice, acholic, choluria, hepatomegaly) and laboratory findings (bilirubin, AST, ALT, ALP, GGT) were noted and analyzed with chi-square and independent t-test. Results: One hundred and nineteen infants with cholestasis were enrolled. Clinical parameters between intrahepatic and extrahepatic neonatal cholestasis included birth-weight (p=0.34), gender (p=0.33), acholic stool (p=0.07), choluria (p=0.29), first presentation of jaundice (p=0.47), and hepatomegaly (p=0.34) were not differed significantly. Laboratory parameters, AST (p=0.87), ALT (p=0.35), alkaline phosphatase (p=0.57), and Gamma-GT (p=0.08) were not differed significantly. Only Total bilirubin (p=0.001), direct bilirubin (p=0.004) were differed significantly, with higher level in extrahepatic neonatal cholestasis. Conclusion: Bilirubin level in intrahepatic and extrahepatic neonatal cholestasis were significantly different.