Clinical manifestations and etiological analysis of 94 neonates with abnormal hepatic enzymes

Abstract

Abstract: Objective The clinical data of 94 neonates with abnormal liver enzymes were retrospectively analyzed, and the clinical manifestations and etiology of abnormal liver enzymes were discussed, so as to provide effective information for early diagnosis and treatment of such patients in clinical practice.Methods From January 2019 to September 2021, 94 neonates with abnormal liver enzymes (56 males and 38 females), aged 22 (10, 25) days, were reviewed. Specific manifestations of abnormal liver enzymes included jaundice, hepatomegaly, splenomegaly, ascites and abnormal coagulation function. To analyze the clinical manifestations and causes of abnormal liver enzymes in neonates.Results Among the 94 neonates with abnormal liver enzymes, 32 cases (34.0%) had specific manifestations of liver damage, and some neonates had simultaneous manifestations, including jaundice in 15 cases (16.0%), hepatosplenomegaly in 9 cases (9.6%), jaundice with hepatosplenomegaly in 2 cases (2.1%), hepatomegaly in 2 cases (2.1%) and splenomegaly in 2 cases (2.1%). According to the primary diseases, clinical manifestations and auxiliary examination Results, 52 cases of infectious diseases (55.3%), 16 cases of non-infectious diseases (30.8%) and 26 cases of unknown causes (27.6%) were found. The causes of infectious diseases included viral infection and bacterial infection, among which viral infection included cytomegalovirus in 14 cases (26.9%), respiratory syncytial virus in 7 cases (13.5%) and enterovirus in 6 cases (11.5%). Bacterial infections included septicemia in 16 cases (30.8%), purulent meningitis in 6 cases (11.5%), intracranial infection in 2 cases (3.8%) and appendicitis in 1 case (1.9%). The causes of non-infectious diseases included anatomical abnormalities, trauma and genetic metabolic diseases, among which anatomical abnormalities included biliary atresia in 6 cases (37.5%), biliary stricture in 4 cases (25.0%) and biliary dilatation in 2 cases (12.5%). Trauma included 2 cases (12.5%) of traumatic organ or soft tissue contusion and 1 case (6.2%) of fracture. Metabolic diseases included glycogen storage disease in 1 case (6.2%).Conclusion Infectious diseases are the main cause of abnormal liver enzymes in neonates, and viral infections are common, among which cytomegalovirus is the most common. Anatomical abnormalities are the most common non-infectious diseases, among which biliary atresia is the most common.

Key words: Neonates, Liver enzymes, Jaundice, Cytomegalovirus, Biliary atresia

XUE Yan, LI De-liang, BIE Jing-yang, CHANG Jun-ming, ZHAO Jie, ZHANG Wei-ye, BAO Feng-yuan, ZHU Ping. Clinical manifestations and etiological analysis of 94 neonates with abnormal hepatic enzymes[J]. Chinese Hepatolgy, 2022, 27(11): 1220-1222.

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