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Refractory cholestasis presenting as cholangiolitis in an Rh (E)‐incompatible neonate
Author(s) -
Taba Ryusuke,
Yamakawa Masaru,
Miyakoshi Chisato,
Imai Yukihiro
Publication year - 2012
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/j.1440-1754.2010.01874.x
Subject(s) - medicine , cholestasis , bile duct , gastroenterology , refractory (planetary science) , prednisolone , bilirubin , jaundice , pathophysiology , immunohistochemistry , pathology , astrobiology , physics
Cholestasis in neonates is infrequently associated with Rh isoimmunization, and usually resolves within a month. The suggested pathophysiology is inspissated bile and hepatocellular damage. We report a rare case of refractory cholestasis presenting with cholangiolitis in a newborn with anti‐E isoimmunisation. The cholangiolitis was disclosed by immunohistochemical investigation of conjugated hyperbilirubinaemia and by liver biopsy, which showed a number of CD8 + lymphocytes within the portal tract damaging the interlobular bile duct. Bilirubin levels dramatically decreased after 14‐day corticosteroid therapy (prednisolone, 2 mg/kg/day) implying that the cause of cholestasis could be immune‐mediated cholangiolitis.