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The mystery of biliary atresia: Why is it the leading cause of neonatal jaundice?
Neonatal jaundice is one of the most common challenges many families face when welcoming a new baby. Among them, biliary atresia is one of the main causes of neonatal jaundice, which has a profound impact on the health of newborns. Biliary atresia is characterized by obstruction of the excretion of bile from the liver, causing conjugated bilirubin to accumulate in the blood, causing jaundice. Although this condition is relatively rare in newborns, it has considerable clinical significance.
Biliary atresia is one of the most common pathologies of the biliary system in the neonatal period, affecting approximately 35-40% of jaundice cases.
Epidemiology of biliary atresia
According to research, the incidence of neonatal biliary atresia is approximately 1 in every 2,500 full-term newborns. Although the cause of jaundice can be quite complex, the causes of jaundice are not limited to biliary atresia. Other causes, such as metabolic and genetic diseases, infectious diseases, etc., may also lead to excessive accumulation of bilirubin.
Causes of biliary atresia
Biliary atresia can be caused by a variety of factors, including but not limited to anatomical abnormalities at birth. Here are some possible causes of biliary atresia:
- Anatomical and structural factors: biliary atresia, bile duct cyst, gallstones, malignant tumors, etc.
- Hereditary and metabolic defects: such as alpha-1 anticystin deficiency, Alagille syndrome, etc.
- Infectious factors: TORCH infection, hepatitis or bacterial infection.
- Toxin effects: drugs, endotoxins, etc.
- Endocrine problems: such as hypothyroidism, etc.
Any structural disturbance in the hepatobiliary system may lead to excessive accumulation of bilirubin, leading to neonatal jaundice.
Clinical manifestations
Although physiologic jaundice is fairly common in newborns, those who continue to have jaundice beyond two weeks of life require further medical evaluation. Most newborns present with:
- Persistent jaundice
- The whites of the eyes turn yellow
- Unexplained poor weight
- Light-colored feces and dark urine
See a doctor as soon as possible to rule out the possibility of biliary atresia.
Diagnostic methods
If a newborn is suspected of having biliary atresia, the doctor will first measure the total bilirubin and conjugated bilirubin levels. The presence of biliary atresia is usually considered when conjugated bilirubin exceeds 20% of total bilirubin or its absolute concentration is greater than 1.0 mg/dL. A follow-up abdominal ultrasound may be needed to detect structural changes in the hepatobiliary system.
In some cases, if the cause cannot be clearly identified through imaging and laboratory tests, genetic testing may be considered to determine whether it is a hereditary disease.
Treatment and Prognosis
Treatment of neonatal biliary atresia depends on the underlying cause. Some babies may recover due to lifestyle adjustments and surgical intervention, while others may develop chronic liver disease or liver failure. For example, people with biliary atresia often need emergency surgery to restore the flow of bile.
Some metabolic diseases, such as glycoketosis, require lifelong avoidance of certain foods. There is no specific treatment for alpha-1 anticystin deficiency, and these children may eventually require liver transplantation because they often develop cirrhosis and related complications.
In short, if a baby faces neonatal jaundice, it is important to seek medical help as early as possible to ensure that any possible causes and opportunities for interventional treatment are not missed. In the face of this mysterious disease, can we gain a deeper understanding of the truth behind neonatal jaundice?
