Algunos aspectos en el estudio clínico, humoral e histológico del síndrome ictérico del recién nacido y lactante menor

Abstract

SUMMARY SOME ASPECTS IN THE CLINICAL, HUMORALAND HISTOLOGICAL STUDY OF JAUNDICE INTHE NEWBORN AND JOUNG INFANTS.A critic review is done on 80 cases ofpathological jaundice in the neonatalperiod and early infancy and an analysisis made on the main clinical and humoralcharacteristics of this casuistry.An histological study is done on frag-ments obtained by needle biopsy of theliver in 13 patients who presented diffe-rent types of jaundice.Clinical study showed precocious ini-tiation in jaundice due to blood incompa-tibilities and a variable period in the ini-tiation of this condition in cases followingsepsis, hepatitis and congenital malfor-mations of the biliary tree. The durationof jaundice in live patients was in generalover two weeks and their longer evolutionwas associated frequently with the appa-rition of acolia, simulating a permanentbiliary obstruction. Hepatomegaly andsplenomegaly were observed in any typeof pathological jaundice, but these signswere more remarkables in erythroblastosisdue to Rh factor.Humoral study allowed us to verifythat highest bilirrubinemias were presentin jaundice due to blood incompatibilities;in these cases we can find too, with lessfrequency, an ascent of direct serum bi-lirrubin, a finding that is the rule in he-patitis, sepsis and congenital malforma-tions of the biliary tree. Floculation testswere positives in all of the cases of hepa-titis and with less intensity in other typesof jaundice; in all of the cases due toblood incompatibility, they were negatives.Histological study don't allow us todraw accurate conclusions, because of thesmall number of patients in which it waspracticed, but we think it can be usefulin some cases as complementary methodfor the differential diagnosis of jaundice.In the cases due to Rh incompatibility, themaintenance of the structure of the liveris the rule and it is constant the presenceof .hematopoietic nests and deposits ofhemosiderin. In hepatitis, on the contraryto what happen in adults, it detachs thelack of degenerative damage of the cells,being frequent a portal infiltration andit can be also observed the presence ofhemosiderin.