DIFFERENTIAL DIAGNOSIS OF LIVER BIOPSY IN AN INFANT WITH DIRECT HYPERBILIRUBINEMIA (NON-HEMOLYTIC JAUNDICE)

• I. Impaired hepatocellular function:

  • A. Infection: Congenital or neonatal (syphilis, rubella, toxoplasmosis, herpes simplex, hep. A and B, etc.).
  • B. Metabolic disorders:
    • 1.Carbohydrates, lipids, aminoacids.
    • 2. Alpha 1 antitrypsin deficiency.
    • 3. Miscellaneous conditions: cystic fibrosis, neonatal iron storage disease, etc.
  • C. Hereditary disorders: Byler’s disease, familial intrahepatic cholestasis.
  • D. Toxic: TPN, Gram negative sepsis.
  • E. Idiopathic:Neonatal hepatitis, syndromatic (Alagille syndrome) and nonsyndromatic bile duct paucity, Zellweger syndrome, Caroli’s disease.

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