PERINATOLOGIYA I PEDIATRIYA.2013.3(55):9–12;doi10.15574/PP.2013.55.9

Clinical and paraclinical characteristics of children with prolonged conjugational jaundice

Lenchenko A. V.

State Institution «Institute of Pediatrics, Obstetrics and Gynecology, NAMS of Ukraine », Kiev, Ukraine

Uzhgorod City Children's Hospital, Ukraine

Objective. To study the risk factors and features of clinical and paraclinical course of prolonged conjugational jaundice (PCJ).

Patients and methods. The anamnesis data, clinical and paraclinical characteristics of the disease were analyzed in 73 children with PCJ in the age from 15 days to 3 months. A set of studies included clinical examination and laboratory tests: general blood analysis, biochemical blood parameters (the level of total bilirubin in blood and its fractions, the activity of the enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) , alkaline phosphatase), bacteriological seeding of the gut, ultrasonography (USG ) of the abdominal cavity. Research data processed by the methods of mathematical statistics, used parametric methods (Student's test). The critical level of significance was taken as 5%. Data analysis was performed by the use of EXCELL XP program.

Results. It is found that the major part of infants (53.43%) with prolonged course of neonatal jaundice has extended antero-posterior size of liver and increased echogenicity of the liver parenchyma that is reflecting a high burden on the liver due to hyperbilirubinemia and prolonged persistence of bilirubin in the children's body. It is possible toxic effect of bilirubin on hepatocytes with its further necrosis or activation of fibrotic processes by the way of stimulating of liver stellar calls. Most of the children with PCJ (63.01%) were born by mothers during the pregnancy and childbirth of which were marked complications that is allows predicting the risk of prolonged flow of conjunctional jaundice before the discharge from the hospital. Premorbid background for the PCJ development is a concomitant pathology of a child that is why so early detection and correction of pathological conditions of the newborn will help reduce the duration of conjunctional jaundice.

Conclusions. Revealed concomitant pathology in the major part of children (hypoxic damage of the central nervous system, functional disorders of the gastrointestinal tract, underweight) confirms its importance in the development of prolonged flow of conjunctional jaundice. Elevated levels of serum transaminases (ALT and AST) in almost every third child, detection of abnormality in the liver by ultrasound in the half of babies with PCJ indicate about the involvement of the liver parenchyma to the pathological process and determine the need for further study of the functional features of the state of the Hepatobiliary system in children with PCJ for optimization of treatment of such pathology.

Key words: conjunctional prolonged jaundice, clinical-anamnestic analysis, hepatobiliary system.

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