NON
OBSTRUCTIVE CHOLESTASIS IN INFANTS & CHILDREN: AETIOLOGY &
TREATMENT
Georgieva-Shakola
M,
Tzaneva V, Konstantinova-Kanazireva D*,
Clinic of
Pediatric Endocrinol & Gastroenterol,
University
Hospital “St. Marina”, Varna, Bulgaria
Objective: Cholestasis occurs in the course of many disorders in
infants & children. Non obstructive cholestasis (NOCh) is more common
in childhood. There are no
lots of data for the treatment of pediatric NOCh with ursodeoxycholic acid
(UDCA). Study’s aim was to
reveal the aetilogy & the treatment of NOCh in children.
Methods: In 1987-2000 NOCh was diagnosed in 92 pts. (15 d.-18
y.). The diagnosis was proved by clinical, laboratory, sonographic,
radiographic, histologic investigation. The treatment was: low fat diet
(36pts.), phenobarbitone (28pts.), vitamin D, E, K (57pts.), cholestyramin (9pts.),
prednison (5pts.), anabolic steroids
(23pts.), UDCA (27). The pts. were treated from 1 months to 4 years.
They were controlated.
Results: Aetiologicaly it was: bacterial sepsis in 18,48%,
hypoalbumin-emia in 16,31%, chronic active B hepatitis in 13,04%, neonatal
viral hepatitis in 10,87%, cholecystocholangiohepatitis in 9,78%, secondary
hemosiderosis in 6,52%, cystic fibrosis in 5,44%, unclear liver disorders
in 5,44%, intrahepatic biliary atresia in 3,26%, syndrome of Alagille,
metastatic cholestasis in 2,17%, Rotor syndrome, secondary sclerosing
cholangitis in 1,09%. In 25/27
pts., treated with UDCA the clinical symptoms were ameliorated:. In 22/27
pts. UDCA lowered the raised
values of aminotransferases, & gammaglutamyltransferase. One patient was with allergy to
UDCA.
Conclusion: The most common causes of pediatric
NOCh were: bacterial sepsis, hypoalbuminemia & viral hepatitis. UDCA is an useful drug
in the treatment of pediatric NOCh.