Cholestasis in Newborn

Abstract

Cytomegalovirus (CMV) is one of the most important intrauterine infections that cause birth defects in humans with hematogenous transmission rate of 0.5% to 2.5%, on average. The early transmission of infection from mother to fetus decreases the prognosis and increases the chances of serious anomalies. The objective of this case report is to instruct the neonatologist that despite the rarity of neonatal cholestasis, this may be a case of intrahepatic cholestasis resulting from congenital cytomegalovirus infection. This study aims to report the case of a 28 weeks and 6 days old child, presenting 1080 g birth weight, Apgar score 5 and 8, untreated sepsis, thrombocytopenia, leukocytosis, and jaundice with predominance in the evolution of direct bilirubin. To find out the cause of jaundice, serum bilirubin levels, serology and PCR (polymerase chain reaction) were performed for cytomegalovirus. Serology for cytomegalovirus was negative in spite of the molecular analysis by PCR in urine samples having demonstrated consistent results with the identification of genomic sequences of cytomegalovirus. Bilirubin values were: Total 15.58 mg%; Direct 12.36 mg%. It was concluded that treatment with ganciclovir resulted in satisfactory clinical response to treatment of cholestatic jaundice source cytomegalovirus.




J Med Cases. 2013;4(7):504-506
doi: https://doi.org/10.4021/jmc1320w