๐Ÿ’› Section 404.1: Neonatal Cholestasis

Nelson Textbook of Pediatrics 22nd Edition โ€” Conjugated hyperbilirubinemia in the newborn is always pathologic. Key etiologies: biliary atresia (surgical emergency), Alagille syndrome (JAG1/NOTCH2), PFIC, alpha-1 antitrypsin deficiency, gestational alloimmune liver disease (GALD), TORCH infections, metabolic disorders. Early diagnosis (<60 days) critical for Kasai procedure outcome.

๐ŸŒ paeds.online โ€” Pakistan's Pediatric Platform

๐Ÿ“‹ 30 Clinical Scenarios โ€” Neonatal Cholestasis

๐Ÿ“‡ Highโ€‘Yield Review Cards (Neonatal Cholestasis)

๐Ÿฉบ Clinical Presentations: Neonatal Cholestasis

Select a presentation for diagnostic clues and etiology.

๐Ÿ“‹ Stepwise Evaluation & Management of Neonatal Cholestasis

๐Ÿ”‘ Key Principles โ€” Nelson 404.1
โ€ข Conjugated hyperbilirubinemia: direct bilirubin >1 mg/dL if total <5 mg/dL OR >20% of total bilirubin.
โ€ข Biliary atresia: most common surgical cause; Kasai before 60 days of life improves native liver survival.
โ€ข Alagille syndrome: JAG1/NOTCH2, paucity of bile ducts, butterfly vertebrae, posterior embryotoxon, peripheral pulmonic stenosis.
โ€ข GALD: presents with liver failure, high ferritin, iron deposition; treat with IVIG + exchange transfusion.
โ€ข Nutritional support: MCT-enriched formula + fat-soluble vitamins (ADEK).

    โšก Reflex Prompts โ€” Clinical Decision Making in Neonatal Cholestasis

    ๐Ÿ“– Neonatal Cholestasis โ€” Core Summary (Nelson 404.1)