Yenidoğan ve süt çocukluğunda kolestaz

Yenidoğan ve süt çocukluğu döneminde kolestatik karaciğer hastalıklarında buna neden olabilecek hastalığın ortaya koyulması önemlidir. Kolestaz, direkt bilirübinin total bilirübin miktarının %20’sinden fazla olmasıdır. Özellikle safra yolları atrezisi, tirozinemi, galaktozemi gibi hastalıklarda erken tanı, ileriye dönük kalıcı hasarların önlenmesi ve erken tedaviden fayda görülmesi açısından önemlidir. Dolayısı ile iki haftayı geçmiş sarılığı olan tüm yenidoğanlarda bilirübin, total, direkt, indirekt olarak bakılmalıdır; total bilürübinin %20’si direkt bilirübin ise karaciğer ile ilgili bozukluklar irdelenmelidir. Bu derlemede kolestatik karaciğer hastalıklarında nedenin ortaya koyulması açısından klinik ve laboratuvar olarak nelere dikkat edilmesi gerekir, bunu göstermeyi amaçladık.

Cholestasis in newborn and infancy period

During the newborn and infancy period, it is an important to demonstrate the condition which causes cholestatic liver diseases. If direct bilirubin level is more than 20% of total bilirübin, it is defined as cholestasis. Especially early diagnosis of diseases including biliary atresia, tyrosinaemia, galactosaemia is crucial for prevention of permanent damage in the future and for benefit from early treatment. Therefore, total, direct and indirect bilirübin levels should be measured in all newborns with jaundice lasting more than two weeks. If 20% of total bilirubin is direct bilirubin, liverrelated disorders should be questioned. In this review, we aimed to show which clinical and laboratory features should be considered to demonstrate the cause of cholestatic diseases.

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