AIM: To determine cytomegalovirus (CMV) frequency in neonatal intrahepatic cholestasis by serology, histological revision (searching for cytomegalic cells), immunohistochemistry, and polymerase chain reaction (PCR), a...AIM: To determine cytomegalovirus (CMV) frequency in neonatal intrahepatic cholestasis by serology, histological revision (searching for cytomegalic cells), immunohistochemistry, and polymerase chain reaction (PCR), and to verify the relationships among these methods.METHODS: The study comprised 101 non-consecutive infants submitted for hepatic biopsy between March 1982 and December 2005. Serological results were obtained from the patient's f iles and the other methods were performed on paraffin-embedded liver samples from hepatic biopsies. The following statistical measures were calculated: frequency, sensibility, specif ic positive predictive value, negative predictive value, and accuracy.RESULTS: The frequencies of positive results were as follows: serology, 7/64 (11%); histological revision, 0/84; immunohistochemistry, 1/44 (2%), and PCR, 6/77 (8%). Only one patient had positive immunohistochemical fi ndings and a positive PCR. The following statistical measures were calculated between PCR and serology: sensitivity, 33.3%; specificity, 88.89%; positive predictive value, 28.57%; negative predictive value, 90.91%; and accuracy, 82.35%. CONCLUSION: The frequency of positive CMV varied among the tests. Serology presented the highest positive frequency. When compared to PCR, the sensitivity and positive predictive value of serology were low.展开更多
AIM:To compare the histologic features of the liver in intrahepatic neonatal cholestasis(IHNC)with infectious,genetic-endocrine-metabolic,and idiopathic etiologies. METHODS:Liver biopsies from 86 infants with IHNC wer...AIM:To compare the histologic features of the liver in intrahepatic neonatal cholestasis(IHNC)with infectious,genetic-endocrine-metabolic,and idiopathic etiologies. METHODS:Liver biopsies from 86 infants with IHNC were evaluated.The inclusion criteria consisted of jaundice beginning at 3 mo of age and a hepatic biopsy during the 1st year of life.The following histologic features were evaluated:cholestasis,eosinophilia,giant cells,erythropoiesis,siderosis,portal fibrosis,and the presence of a septum. RESULTS:Based on the diagnosis,patients were classified into three groups:group 1(infectious;n=18),group 2(genetic-endocrine-metabolic;n=18),and group 3(idiopathic;n=50).There were no significant differences with respect to the following variables:cholestasis,eosinophilia,giant cells,siderosis,portalfibrosis,and presence of a septum.A significant difference was observed with respect to erythropoiesis,which was more severe in group 1(Fisher's exact test,P=0.016). CONCLUSION:A significant difference was observed in IHNC of infectious etiology,in which erythropoiesis was more severe than that in genetic-endocrine-metabolic and idiopathic etiologies,whereas there were no significant differences among cholestasis,eosinophilia,giant cells,siderosis,portal fibrosis,and the presence of a septum.展开更多
基金Supported by The State of So Paulo Research Foundation (Fapesp)and the Coordination for Higher Level Graduates Improvement (Capes)
文摘AIM: To determine cytomegalovirus (CMV) frequency in neonatal intrahepatic cholestasis by serology, histological revision (searching for cytomegalic cells), immunohistochemistry, and polymerase chain reaction (PCR), and to verify the relationships among these methods.METHODS: The study comprised 101 non-consecutive infants submitted for hepatic biopsy between March 1982 and December 2005. Serological results were obtained from the patient's f iles and the other methods were performed on paraffin-embedded liver samples from hepatic biopsies. The following statistical measures were calculated: frequency, sensibility, specif ic positive predictive value, negative predictive value, and accuracy.RESULTS: The frequencies of positive results were as follows: serology, 7/64 (11%); histological revision, 0/84; immunohistochemistry, 1/44 (2%), and PCR, 6/77 (8%). Only one patient had positive immunohistochemical fi ndings and a positive PCR. The following statistical measures were calculated between PCR and serology: sensitivity, 33.3%; specificity, 88.89%; positive predictive value, 28.57%; negative predictive value, 90.91%; and accuracy, 82.35%. CONCLUSION: The frequency of positive CMV varied among the tests. Serology presented the highest positive frequency. When compared to PCR, the sensitivity and positive predictive value of serology were low.
文摘AIM:To compare the histologic features of the liver in intrahepatic neonatal cholestasis(IHNC)with infectious,genetic-endocrine-metabolic,and idiopathic etiologies. METHODS:Liver biopsies from 86 infants with IHNC were evaluated.The inclusion criteria consisted of jaundice beginning at 3 mo of age and a hepatic biopsy during the 1st year of life.The following histologic features were evaluated:cholestasis,eosinophilia,giant cells,erythropoiesis,siderosis,portal fibrosis,and the presence of a septum. RESULTS:Based on the diagnosis,patients were classified into three groups:group 1(infectious;n=18),group 2(genetic-endocrine-metabolic;n=18),and group 3(idiopathic;n=50).There were no significant differences with respect to the following variables:cholestasis,eosinophilia,giant cells,siderosis,portalfibrosis,and presence of a septum.A significant difference was observed with respect to erythropoiesis,which was more severe in group 1(Fisher's exact test,P=0.016). CONCLUSION:A significant difference was observed in IHNC of infectious etiology,in which erythropoiesis was more severe than that in genetic-endocrine-metabolic and idiopathic etiologies,whereas there were no significant differences among cholestasis,eosinophilia,giant cells,siderosis,portal fibrosis,and the presence of a septum.
