Why are neonates at higher risk for cholestasis?

Updated: Aug 09, 2017
  • Author: Hisham Nazer, MBBCh, FRCP, DTM&H; Chief Editor: Carmen Cuffari, MD  more...
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Answer

Owing to an immaturity of hepatobiliary function, the number of distinct disorders presenting with cholestatic jaundice may be greater during the neonatal period than at any other period. The differential diagnosis of cholestasis in neonates and infants is therefore much broader than in older children and adults. This is because the immature liver is relatively sensitive to injury, and the response of the immature liver is more limited. Cholestasis develops in response to a wide variety of insults. Although the reasons for this are not entirely clear, it is considered the result of immaturity of several critical mechanisms of bile formation. So-called physiologic cholestasis of infancy results from immaturity of these mechanisms. Early enteral feedings as tolerated is the best way to prevent and manage cholestasis in preterm infants. [5]


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