All issues > Volume 32(11); 1989

Original Article

J Korean Pediatr Soc. 1989;32(11):1474-1481. Published online November 30, 1989.

A study of neonatal cholestasis and cytomegalovirus infection.

Moon A Kim¹, Ki Sup Chung¹

¹Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea

Received: July 7, 1989;  Accepted: July 7, 1989.

Abstract

A clinical assessment of 25 patients with neonatal cholestasis caused by cytomegalovirus infection who were admitted to the Department of Pediatrics, Yonsei University College of Medicine from January 1983 to July 1988 was performed. The results were as follows: 1) The patients with neonatal cholestasis caused by cytomegalovirus infection were 19% of the total patients with neonatal cholestasis from January 1983 to July 1988 and were over 30% annually since 1987. 2) Among 25 cases, 21 cases were neonatal hepatitis, 2 cases biliary atresia and the remaining 2 cases neonatal hepatitis with biliary atresia. 3) Seventy six percent of the patients were 2—3 months of age and 13 cases were male and 12 cases were female. 4) Thirty two percent of the patients were low birth weight infants and 18% were premature neonates. 5) Hepatomegaly was present in all 25 cases. Jaundice and splenomegaly were noted in 96%, and acholic stool was noted in 56%. Congenital anomalies were noted in 12% of the patients. 6) There were no statistical differences in laboratory findings between the patients with acholic stool and those without. 7) Among 23 cases who were treated medically, 14 cases improved, 7 cases deteriorated and 2 cases died. Two cases who received Kasai operation died during the follow up period. 8) During the follow up period <1 〜 24 months), 28% of the patients recovered, 28% progressively improved, 4% progressively deteriorated, 4% were stationary, and 16% died. 9) The proposed prognostic factors such as gestational age over 37 weeks, birth weight above 2.5 kg, age of onset of jaundice over 2 weeks after birth and absence of cirrhotic change were related to a favorable outcome even though statistically insignificant. In contrast, patients with acholic stool or biliary atresia were associated with poor prognosis with statistical significance.

Keywords :Neonatal Cholestasis, Cytomegalovirus Infection