Diagnostic Evaluation for Neonatal Cholestasis
Etiology | Test |
|---|---|
Hepatic dysfunction | |
Infections | Urine cultures, TORCH titers, HIV screening and other hepatitides (hepatitis A, B, and C) |
Endocrinopathy | |
Sweat chloride test, review of newborn screening test | |
Neonatal screen, reducing substances (eg, galactose) in urine (see diagnosis of galactosemia) | |
Serum levels of alpha-1 antitrypsin, alpha-1 antitrypsin phenotype testing | |
Genetic errors in bile acid synthesis | Bile acid levels in urine and serum |
Urine organic acids, serum ammonia, serum electrolytes (see testing of inherited disorders of metabolism) | |
Alloimmune liver disease | Review of maternal obstetrical history for fetal deaths and/or prior infants with cholestasis Alpha fetoprotein, ferritin, lipid profile |
ALT = alanine aminotransferase; AST = aspartate aminotransferase; GGT = gamma-glutamyl transpeptidase; prothrombin time/partial thromboplastin time = PT/PTT; TORCH = toxoplasmosis, other pathogens, rubella, cytomegalovirus, and herpes simplex; TSH = thyroid-stimulating hormone. | |