What causes (rare) cholestasis in paediatric patients?
Once neonatal cholestasis is confirmed, a systematic approach is the key to reliably achieve the diagnosis in order to promptly initiate the specific, and in many cases, life-saving therapy.1
Diagnostic algorithms for cholestasis
Newborns
Infants/Children
MISTAKES TO AVOID AT ALL COSTS 2
- Considering jaundice that last >10 days as physiological
- Being overly confident of a diagnosis of breast milk jaundice
- Mistaking added colouration to the stools (of nutritional and/or pharmaceutical origin)
- Ignoring the discolouration of the stools
- Viewing a normal growth curve as reassuring
- Being reassured by the presence of a gall bladder on the abdominal ultrasound
Age definitions3
Neonate: 0-30 days
Infant: 1 month-2 years
Young child: 2-6 years
Child: 6-12 years
Adolescent: 12-18 years
MISTAKES TO AVOID AT ALL COSTS 2
- Considering jaundice that last >10 days as physiological
- Being overly confident of a diagnosis of breast milk jaundice
- Mistaking added colouration to the stools (of nutritional and/or pharmaceutical origin)
- Ignoring the discolouration of the stools
- Viewing a normal growth curve as reassuring
- Being reassured by the presence of a gall bladder on the abdominal ultrasound
Age definitions3
Newborn/neonate: 0-30 days
Infant: 1 month-2 years
Young child: 2-6 years
Child: 6-12 years
Adolescent: 12-18 years
1. Götze T, Blessing H, Grillhösl C, et al. Neonatal cholestasis – differential diagnoses, current diagnostic procedures, and treatment. Front Pediatr. 2015;3:43.
2. Protocole national de diagnostic et de soins : Déficits de synthèse des acides biliaires primaires. In: Génétiques CdRCdlAdVBedC, ed., 2019.
3. 2007; Position paper: Paediatric age categories to be used in differentiating between listing on a model essential medicines list for children. Accessed at World Health Organization website on April 2020.
CTRS-INSTIT-PLATEDUC-ONG02/20/07/20
