neonatal hepatitis
Introduction
Introduction to neonatal hepatitis For a group of clinical syndromes in the neonatal period, the main manifestations are obstructive jaundice, hepatic enlargement and liver function damage. Because of the high number of causes, the exact cause of each case is difficult to determine, so it is often called neonatal hepatitis synthesis. (NeonatalHepatitisSyndrome). Neonatal hepatitis includes hepatitis B caused by hepatitis B virus, cytomegalovirus, herpes simplex virus, coxsackie virus and rubella virus, and can also be caused by ECHO virus, Epstein-Barr virus, Toxoplasma gondii, Listeria or various bacteria Caused. These pathogens can infect the fetus through the placenta and can also be infected during labor or postpartum. A few cases are associated with congenital metabolic defects. basic knowledge The proportion of illness: 0.001% Susceptible people: infants and young children Mode of transmission: mother-to-child transmission Complications: liver cirrhosis, children with hepatic encephalopathy, neonatal rickets, rickets, pediatric gastrointestinal bleeding
Cause
Neonatal hepatitis etiology
Virus infection (45%)
Neonatal hepatitis is mostly caused by a virus in the mother. It usually develops jaundice 1-3 weeks after birth and continues to increase. Some children have recurrence of jaundice after the physiological jaundice subsides. At the same time, there are performances such as not eating milk, vomiting and not increasing weight. The color of the stool is normal at birth, and then gradually turns pale yellow or grayish white, and the color of the urine is dark yellow. Including cytomegalovirus, various hepatitis viruses and the like.
Metabolic defects (20%)
Clinically, there is a certain number of cases related to congenital metabolic defects, such as galactosemia, 1-anti-pancreatic plum deficiency, etc. These factors can cause neonatal metabolic disorders, produce hepatotoxic substances that the body cannot metabolize, and damage the liver. Inducing neonatal hepatitis.
Other factors (8%)
Such as cholestasis or intrahepatic and external biliary atresia.
Prevention
Neonatal hepatitis prevention
Pregnant women of childbearing age should be screened for infection of hepatitis B as soon as possible. For pregnant women with HBsAg positive and HBsAg and e antigen double positive, one injection of hepatitis B immunoglobulin per month is given from the first 3 months before the expected date of delivery. The dose is 200-400 IU, the hepatitis B immunoglobulin is injected within 24 hours after birth, the dose is 200 IU, and the hepatitis B vaccine can be injected at the same time; 1 injection of hepatitis B immunoglobulin is given 2 weeks after birth, the dose is 200 IU, the newborn full moon and 6 One dose of hepatitis B vaccine will be given every month. After that, the immunization will be implemented as soon as possible, and the relevant preventive measures will be implemented in time to block more than 85% of mother-to-child transmission. For pregnant women who have not found the infection mark, the newborns should be safe. Hepatitis B vaccine is given in time according to the planned immunization program prescribed by the state.
Complication
Neonatal hepatitis complications Complications, cirrhosis, pediatric hepatic encephalopathy, neonatal rickets, pediatric gastrointestinal bleeding
The prognosis is better, 60% to 70% can be cured, and less cirrhosis or death.
Symptom
Neonatal hepatitis symptoms Common symptoms Jaundice face gray dyspepsia Appetite decline Nausea liver qi stagnation Taoqi infection
The onset is slower, and jaundice often occurs within a few days to several weeks after birth. It lasts for a long time and may be accompanied by decreased appetite, nausea, vomiting, indigestion, and weight loss. The color of the stool becomes lighter. Grayish white, but sometimes shallow, dynamic changes in depth, dark urine, mild to moderate swelling of the liver, slightly harder, a few spleens are also large, toxic hepatitis often has infection and systemic symptoms, rubella virus Hepatitis caused by cytomegalovirus is often accompanied by congenital malformations or intrauterine growth disorders.
Examine
Neonatal hepatitis check
Laboratory examination of serum transaminase increased, bilirubin increased, combined with increased bilirubin, early changes in flocculation turbidity test is not obvious, alpha-fetoprotein positive, urinary bile positive, urinary bilirubin according to the degree of bile duct obstruction Positive or negative reaction, blood test for hepatitis B virus surface antigen, collection of baby urine or maternal smear for giant cell inclusions can be used for etiological diagnosis.
Diagnosis
Diagnosis and diagnosis of neonatal hepatitis
diagnosis
Diagnosis can be made based on medical history, clinical manifestations, and examination.
Differential diagnosis
The early clinical manifestations and signs of biliary atresia and neonatal hepatitis are similar, all of which have jaundice and hepatomegaly. Therefore, the identification of the two is difficult, but there are two distinct clinical developments of the disease, and they are completely different. Treatment: The former can only obtain early bile drainage through early surgery, and hope to obtain survival hope; while the latter can be cured by medical treatment. Therefore, the early diagnosis of biliary atresia and neonatal hepatitis It is especially important to make a diagnosis. In clinical practice, a comprehensive analysis is needed in combination with medical history, physical examination, laboratory and imaging studies to make a correct judgment.
