Ocular findings in patients with cholestatic disorders of infancy: A single-centre experience
| Autor: | Heba Helmy, Hanaa El-Karaksy, Fotouh Hasanain, Dalia Ahmed Hamed, Hanan Fouad, Engy A. Mogahed |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Intraocular pressure Cholestasis Intrahepatic Comorbidity Fundus (eye) Gastroenterology 03 medical and health sciences 0302 clinical medicine Cholestasis Biliary Atresia Biliary atresia Internal medicine Alagille syndrome medicine Humans Eye Abnormalities Neonatal cholestasis Niemann-Pick Diseases Optic Disk Drusen business.industry Infant Newborn Infant Hepatology medicine.disease eye diseases Alagille Syndrome Neonatal hepatitis Cross-Sectional Studies 030221 ophthalmology & optometry Egypt Female 030211 gastroenterology & hepatology business |
| Zdroj: | Arab Journal of Gastroenterology. 18:108-113 |
| ISSN: | 1687-1979 |
| DOI: | 10.1016/j.ajg.2017.05.006 |
| Popis: | Background and study aims Neonatal cholestasis can be associated with ocular findings that might aid in its diagnosis, e.g., Alagille syndrome (AGS) and Niemann Pick disease (NPD). We aimed to investigate the frequency of ocular manifestations in infants with cholestasis. Patients and methods This cross-sectional study included cholestatic infants presenting to the Paediatric Hepatology Unit, Cairo University Paediatric Hospital, Cairo, Egypt. All infants underwent examination of lid, ocular motility, anterior and posterior segments and measurement of intraocular pressure, cycloplegic refraction, ocular ultrasonography and vision. Results The study included 112 infants with various cholestasis; 73 (65.2%) were males. The median age was 2 months. Diagnosis was reached in 39 cases: 14 had AGS, 14 had biliary atresia (BA), 4 had NPD, 4 had post-haemolytic cholestasis, 2 had cytomegalovirus neonatal hepatitis, and one case had hepatorenal tyrosinaemia. Thirteen cases were probably having progressive familiar intrahepatic cholestasis (PFIC) type 1 or 2 considering their persistent cholestasis in the presence of normal gamma-glutamyl transpeptidase; 28 were left with a diagnosis of “idiopathic neonatal hepatitis” (INH), and 32 (28.6%) had no definite diagnosis. Ophthalmologic abnormalities were found in 39 cases (34.8%). The commonest finding was unilateral/bilateral optic nerve drusen in 12 (10.7%), followed by posterior embryotoxon in 11 (9.8%). Ocular findings were observed in 64.3% patients with AGS, 50% patients with NPD, 30.8% cases with suspected PFIC type 1or 2, 28.6% infants with INH, and 14.3% patients with BA. Conclusion Ophthalmologic findings are not uncommon among cholestatic infants. Ophthalmologic examination should be routinely performed, including assessment of anterior segment, fundus examination, and ocular ultrasound. |
| Databáze: | OpenAIRE |
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