{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T08:49:57Z","timestamp":1787993397102,"version":"build-2784847793"},"reference-count":13,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,4,1]]},"abstract":"<jats:p>Gestational alloimmune liver disease has emerged as the major cause of antenatal liver injury and failure. It usually manifests as neonatal liver failure with hepatic and extrahepatic iron overload, a clinical presentation called neonatal hemochromatosis. We report on a newborn in whom fetal hepatomegaly was detected during pregnancy and who presented at birth with liver cirrhosis and mild liver dysfunction. Liver biopsy showed the absence of iron overload but strong immunostaining of hepatocytes for the C5b-9 complex, the terminal complement cascade neoantigen occurring specifically during complement activation by the immunoglobulin G-mediated classic pathway, which established the alloimmune nature of the hepatocyte injury. The infant survived with no specific therapy, and follow-up until 36 months showed progressive normalization of all liver parameters. This case report expands the recognized clinical spectrum of congenital alloimmune liver disease to include neonatal liver disease and cirrhosis, even in the absence of siderosis. Such a diagnosis is of utmost importance regarding the necessity for immunotherapy in further pregnancies to avoid recurrence of alloimmune injury.<\/jats:p>","DOI":"10.1542\/peds.2011-0568","type":"journal-article","created":{"date-parts":[[2012,3,6]],"date-time":"2012-03-06T04:16:41Z","timestamp":1331007401000},"page":"e1076-e1079","source":"Crossref","is-referenced-by-count":36,"title":["Neonatal Liver Cirrhosis Without Iron Overload Caused by Gestational Alloimmune Liver Disease"],"prefix":"10.1542","volume":"129","author":[{"given":"Francois-Guillaume","family":"Debray","sequence":"first","affiliation":[{"name":"Departments of Medical Genetics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"de Halleux","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ornella","family":"Guidi","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Detrembleur","sequence":"additional","affiliation":[{"name":"Pathology, CHU & University of Li\u00e8ge, Li\u00e8ge, Belgium;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phanie","family":"Gaillez","sequence":"additional","affiliation":[{"name":"Departments of Medical Genetics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e9on","family":"Rausin","sequence":"additional","affiliation":[{"name":"Medical Imaging, CHR Citadelle, Li\u00e8ge, Belgium;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Goyens","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, HUDERF, Brussels, Belgium; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomin","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Memorial Hospital, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter F.","family":"Whitington","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Memorial Hospital, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2012,4,1]]},"reference":[{"issue":"3","key":"2021120903531140500_B1","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/S0889-8553(03)00050-5","article-title":"Neonatal hemochromatosis","volume":"32","author":"Knisely","year":"2003","journal-title":"Gastroenterol Clin North Am"},{"issue":"9446","key":"2021120903531140500_B2","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.1016\/S0140-6736(04)17356-X","article-title":"High-dose immunoglobulin during pregnancy for recurrent neonatal haemochromatosis","volume":"364","author":"Whitington","year":"2004","journal-title":"Lancet"},{"issue":"6","key":"2021120903531140500_B3","doi-asserted-by":"crossref","first-page":"2061","DOI":"10.1002\/hep.23581","article-title":"Novel mechanism of fetal hepatocyte injury in congenital alloimmune hepatitis involves the terminal complement cascade","volume":"51","author":"Pan","year":"2010","journal-title":"Hepatology"},{"issue":"4","key":"2021120903531140500_B4","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.jpeds.2011.03.048","article-title":"Gestational alloimmune liver disease in cases of fetal death","volume":"159","author":"Whitington","year":"2011","journal-title":"J Pediatr"},{"issue":"5","key":"2021120903531140500_B5","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1111\/j.1399-3046.2005.00357.x","article-title":"Neonatal hemochromatosis: fetal liver disease leading to liver failure in the fetus and newborn","volume":"9","author":"Whitington","year":"2005","journal-title":"Pediatr Transplant"},{"issue":"5","key":"2021120903531140500_B6","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1007\/s00431-010-1309-1","article-title":"Neonatal liver failure: aetiologies and management\u2014state of the art","volume":"170","author":"Shanmugam","year":"2011","journal-title":"Eur J Pediatr"},{"key":"2021120903531140500_B7","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.yapd.2008.07.018","article-title":"Newborn illnesses caused by transplacental antibodies","volume":"55","author":"Hoftman","year":"2008","journal-title":"Adv Pediatr"},{"issue":"1","key":"2021120903531140500_B8","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/00005176-198801000-00009","article-title":"Familial neonatal hemochromatosis with survival","volume":"7","author":"Colletti","year":"1988","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"6","key":"2021120903531140500_B9","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2005-0784","article-title":"Disparate clinical presentation of neonatal hemochromatosis in twins","volume":"116","author":"Ekong","year":"2005","journal-title":"Pediatrics"},{"issue":"3","key":"2021120903531140500_B10","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1097\/MPG.0b013e318046772f","article-title":"Regression of severe fibrotic liver disease in 2 children with neonatal hemochromatosis","volume":"46","author":"Ekong","year":"2008","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"5","key":"2021120903531140500_B11","first-page":"1312","article-title":"Hepatic morphology and iron quantitation in perinatal hemochromatosis. 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