Zusammenfassung
Neugeborenenikterus wird häufig beobachtet. Ein prolongierter Ikterus kann mit einer Lebererkrankung zusammenhängen. Eine frühe Differenzierung zwischen physiologischem Ikterus und Lebererkrankungen ist durch die Bestimmung des direkten Bilirubins möglich. Eine direkte Hyperbilirubinämie kann Zeichen einer cholestatischen Lebererkrankung sein, die durch Infektionen, Veränderung der Gallenwegmorphologie oder ererbte Transportstörungen für Gallebestandteile und Stoffwechselerkrankungen verursacht werden kann. Die rasche Identifikation der Ätiologie ist wichtig, um rechtzeitig eine adäquate Behandlung beginnen zu können. Im vorliegenden Beitrag werden neue Entwicklungen in der Diagnostik und Therapie cholestatischer Lebererkrankungen beim Säugling diskutiert.
Abstract
Neonatal jaundice is common; however, prolonged icterus can be associated with liver disease. In jaundiced babies, it is important to distinguish cholestatic liver disease from physiologic jaundice. Detection of direct hyperbilirubinemia points to cholestatic hepatic dysfunction, which can be caused by infection, changes in biliary tree morphology, genetic dysfunction in bile flow as well as metabolic disease. Early aetiological identification is essential in order to initiate appropriate treatment. This overview discusses recent advances in diagnostic strategies and treatment of cholestatic liver disease in infants.
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Sturm, E. Lebererkrankungen des Säuglings. Monatsschr Kinderheilkd 158, 1086–1094 (2010). https://doi.org/10.1007/s00112-010-2235-z
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DOI: https://doi.org/10.1007/s00112-010-2235-z