2017 Yılı İçinde Hastanemizdeki Laboratuar Tetkiklerinde Kolestaz Saptanmış Olan 0-18 Yaş Arası Hastaların Etiyolojik Dağılımının Araştırılması

Abstract

Cholestasis is a pathological condition at any age, which can be due to many causes. In our study, clinical, demographic, laboratory characteristics and follow-up of 216 cholestasis patients, 105 (48,6%) female and 111 (51,2%) male, who were admitted to our hospital within one year were evaluated. Twenty-one patients (9,7%) were undiagnosed while cholestasis was due to extrahepatic causes in 21 patients (10,8%) and intrahepatic causes in 174 patients (89,2%). Intrahepatic causes included infection in 57 patients (29,2%), hereditary metabolic diseases in 24 patients (12,3%), autoimmunity in 6 patients (3,1%), systemic diseases in 52 patients (26,7%) and other causes in 35 patients (17,9%). Ninety-two (42,9%) of the patients were in the neonatal period; hereditary metabolic diseases were more common in this group. Only 2 (%1) patients had neonatal idiopathic hepatitis. The mean age was greater in autoimmunity and infection-related cholestasis. Sixty-three patients (32,3%) had consanguinity between their parents; this rate was close to 70% in the hereditary metabolic disease group. 73,8% of the patients were followed for a chronic disease. Acolic stool and jaundice were more frequent in extrahepatic and pruritus in intrahepatic cholestasis. 40% of the patients had malnutrition. All physical examination findings were more frequent and ALP, GGT, bilirubin levels were higher in extrahepatic cholestasis. 33,9% of patients died, and the highest rate was in the systemic causes-related. As a result, the etiologic distribution in cholestasis is very wide. In our study, it was shown once again that physical examination and laboratory tests alone are not sufficient to reveal the cause of cholestasis, a systematic approach and comprehensive tests are necessary for diagnosis. Due to advences in the diagnostic field, the specific cause of cholestasis can be identified in the majority of patients.