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Practical Approach to the Jaundiced Infant

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Pediatric Hepatology and Liver Transplantation

Abstract

Neonatal jaundice is very common in the first days of life. However, jaundice should have resolved after 14 days of age. Prolonged jaundice can be associated with liver disease. In jaundiced infants, it is important to distinguish cholestatic liver disease from physiologic jaundice. Breast milk jaundice is elevation of unconjugated bilirubin due to high level of maternal hormones in breast milk. In contrast, detection of direct hyperbilirubinemia points to cholestatic hepatic dysfunction. A wide range of hepatic and extrahepatic disease including infection, structural and inflammatory abnormalities of biliary tree, and genetic alterations in determinants of the enterohepatic circulation as well as metabolic disease can cause neonatal cholestasis. Therefore, a stepwise risk-adapted diagnostic approach is important to identify etiology early in the course of disease and to initiate appropriate treatment. Here, we present the relevant investigations, discuss a risk-adapted diagnostic algorithm, and give an overview over the differential diagnosis of jaundice in infants.

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  1. University Children’s Hospital Tübingen, Tübingen, Germany

    Ekkehard Sturm & Steffen Hartleif

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  1. Paediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII Bergamo, Bergamo, Italy

    Lorenzo D'Antiga

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Sturm, E., Hartleif, S. (2019). Practical Approach to the Jaundiced Infant. In: D'Antiga, L. (eds) Pediatric Hepatology and Liver Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-96400-3_6

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