{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T10:51:39Z","timestamp":1787827899242,"version":"build-2784847793"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background:<\/jats:title>\n Cholestatic disorders are a significant cause of morbidity and mortality in infants. Characterization of these disorders and differentiating biliary atresia (BA) from other causes of intrahepatic cholestasis is an age-old problem.<\/jats:p>\n <\/jats:sec>\n \n Objectives:<\/jats:title>\n To study the spectrum of different infantile cholestatic disorders in our population, to differentiate BA from other causes of neonatal cholestasis (NC) on a liver biopsy, and validation of the available scoring system for the characterization of these disorders.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n This is an observational cross-sectional study performed over a period of 3 years between 2018 and 2021, done on neonates and infants presenting with cholestatic jaundice. The changes on liver biopsy were evaluated by different histological parameters and available scoring systems to differentiate BA from non-BA causes. Correlation with clinical, biochemical, and imaging findings was done in all cases.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n This study included 87 cases of NC, of which BA comprised 28 cases (32%), whereas idiopathic neonatal hepatitis (INH) comprised only 12 cases (14%). Portal neutrophilic inflammation (\n P<\/jats:italic>\n = 0.000053), ductal cholestasis (\n P<\/jats:italic>\n < 0.001), neoductular bile plugs (\n P<\/jats:italic>\n < 0.001) and bile ductular proliferation (\n P<\/jats:italic>\n < 0.0001) were significantly more in BA, whereas lobular lymphocytic inflammation (\n P<\/jats:italic>\n = 0.001) and giant cell transformation of hepatocytes (\n P<\/jats:italic>\n = 0.0024) were more frequent in the non-BA group. Using the Lee and Looi scoring system, a histologic score \u22657 was helpful in identifying BA with 85.7% sensitivity, 92.6% specificity, and 90.6% accuracy.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n BA is the commonest cause of NC in neonates, whereas the frequency of INH is declining. Detailed histomorphologic analysis of liver biopsy, aided with IHC, is the cornerstone for the diagnosis of these disorders.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijpm.ijpm_215_22","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T02:40:09Z","timestamp":1717036809000},"page":"790-798","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Differentiating biliary atresia from other causes of infantile cholestasis: An appraisal of the histomorphological changes on liver biopsy"],"prefix":"10.4103","volume":"66","author":[{"given":"Aniket","family":"Halder","sequence":"first","affiliation":[{"name":"Department of GI Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabita","family":"Patra","sequence":"additional","affiliation":[{"name":"Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bappa","family":"Mandal","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gautam","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranajoy","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of GI Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suchandra","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uttara","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,2,3]]},"reference":[{"key":"R1-20240829","first-page":"43","article-title":"Neonatal cholestasis-Differential diagnoses, current diagnostic procedures, and treatment","volume":"3","author":"G\u00f6tze","year":"2015","journal-title":"Front Pediatr"},{"key":"R2-20240829","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1053\/siny.2002.0103","article-title":"Neonatal cholestasis","volume":"7","author":"McKiernan","year":"2002","journal-title":"Semin Neonatol"},{"key":"R3-20240829","first-page":"1184","article-title":"Early diagnosis of neonatal cholestatic jaundice: Test at 2 weeks","volume":"55","author":"Benchimol","year":"2009","journal-title":"Can Fam Physician"},{"key":"R4-20240829","first-page":"115","article-title":"Guideline for the evaluation of cholestatic jaundice in infants: Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition","volume":"39","author":"Moyer","year":"2004","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"R5-20240829","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.3748\/wjg.v20.i4.1048","article-title":"Biopsy-driven diagnosis in infants with cholestatic jaundice in Iran","volume":"20","author":"Talachian","year":"2014","journal-title":"World J Gastroenterol"},{"key":"R6-20240829","doi-asserted-by":"crossref","first-page":"101","DOI":"10.4103\/0377-4929.59194","article-title":"A histopathological study of liver and biliary remnants with clinical outcome in cases of extrahepatic biliary atresia","volume":"53","author":"Roy","year":"2010","journal-title":"Indian J Pathol Microbiol"},{"key":"R7-20240829","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1097\/PAS.0000000000000755","article-title":"Childhood liver disease research network (ChiLDReN). 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