Neonatal hepatitis

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 2, 2017
StartDiseasesNeonatal hepatitis

Neonatal hepatitis is hepatitis or inflammation of the liver in an infant.

Contents

Definition & Facts

There are various reasons for this condition to develop, including viral infections and congenital structural abnormalities of the liver. Neonatal hepatitis may lead to the diagnosis of another condition, or it may fully resolve on its own. 

Symptoms & Complaints

Symptoms of neonatal hepatitis include jaundice, a symptom in which the skin appears slightly yellowish, and/or the eyes develops a yellow hue. This is caused by an increase in the bilirubin produced by the liver. If it does not present while the infant is still in the hospital, it will present by the time the infant is two months of age.

Because of inflammation, the bile ducts in the liver become blocked, preventing the bile from exiting the liver. Bile is a naturally occurring chemical in the liver that is responsible for digesting fats and absorbing vitamins that fall into the fat-soluble spectrum.

Because of this, the infant may not gain weight at the expected intervals or grow according to the standard growth chart. Many infants with this condition who are examined via ultrasound will show an enlarged liver (hepatomegaly), and possibly an enlarged spleen (splenomegaly).

Causes

There are a large number of conditions that can result in the development of neonatal hepatitis. The condition can be caused by a virus, infections, immature liver, and other health problems that cause stress on the liver. A case of idiopathic neonatal hepatitis with no primary cause will resolve itself over the course of a few weeks.

Some infants who suffer from neonatal hepatitis do show some level of liver damage for the first few months, called fibrosis. This condition usually resolves on its own over the period of a few months, but should be closely monitored to ensure that it fully resolves without further complication.

Diagnosis & Tests

Neonatal hepatitis is diagnosed by ruling out other conditions. This means that if there is no primary cause, a general diagnosis of neonatal hepatitis is given. Infants who have developed jaundice, which is a common problem in newborns, will be tested for other possible disorders that can lead to the symptom of neonatal hepatitis.

Tests will include screening for viral infections, bacterial infections, metabolic disorders, abnormalities in the structure of the liver, and any genetic disorder that can lead to the development of an inflamed liver.

Many cases of neonatal hepatitis respond best when they are treated early so regular testing is performed on babies over the first few months of life. It is important to identify the cause of the problem, so a liver biopsy may be necessary. Regular lab work and physical examinations can detect the problem before physical symptoms are evident. If there is no primary disorder found, a general diagnosis of neonatal hepatitis or jaundice is given.

Treatment & Therapy

Currently, there is no specific, or general recommendation for the treatment of neonatal hepatitis. Newborns and infants who display jaundiced skin or eyes are considered to have an impaired flow of bile from the liver. This restricts the ability of the infant absorbing vitamins that fall into the fat-soluble spectrum. Vitamin supplementation or special formula may be recommended to guarantee the infant is able to grow and gain weight adequately while the condition is present.

Once the condition has fully resolved, which usually takes around two weeks, the infant will be able to return to a standard, vitamin rich formula or breastfeeding.

In severe cases, medication and light therapy may be recommended to increase the ability of bile to flow through the bile ducts. In most cases with no primary cause, neonatal hepatitis will resolve quickly on its own. Once the jaundice look in the skin and eyes has disappeared, the inflammation has dramatically decreased.

After the inflammation has faded, some infants who suffered from a severe case may show some signs of liver damage until their liver has had time to completely heal. This liver damage is usually limited to a condition called fibrosis and it does improve over time. Neonatal hepatitis rarely causes long-term damage, but if it does the child will require regular monitoring until the condition resolves completely. It is important to note that infants who suffer from neonatal hepatitis are not at any higher risk of developing liver disease later in life, it is considered a problem that is isolated to the short period surrounding birth.

Prevention & Prophylaxis

Since there are a large number of possible contributing factors, it is not possible to prevent this condition from occurring. In many cases, the condition is only the result of an immature liver, or the immune system not being mature enough to fight off infection.

By giving birth in a hospital setting that is appropriately sterile, parents can reduce the chance of their baby developing an infection or contracting a virus that leads to this condition.