WordNet

relating to or affecting the infant during the first month after birth; "neonatal care"; "the neonatal period"
inflammation of the liver caused by a virus or a toxin

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新生児の
肝[臓]炎

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/19 00:38:12」(JST)

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Neonatal hepatitis is a form of hepatitis that affects the fetuses and neonates

Definition

Neonatal hepatitis is inflammation of the liver that occurs only in early infancy, usually between one and two months after birth. About 20 percent of the infants with neonatal hepatitis are infected by a virus that caused the inflammation before birth by their mother or shortly after birth. These include cytomegalovirus, rubella (German measles), and hepatitis A, B or C viruses. In the remaining 80 percent of the cases no specific virus can be identified as the cause, but many experts suspect that a virus is to blame.

Symptoms and Diagnosis

The infant with neonatal hepatitis usually has jaundice (yellow eyes and skin), that appear at one to two months of age, is not gaining weight and growing normally, and has an enlarged liver and spleen. The infant cannot absorb vitamins for proper growth.

The jaundice is caused by the child's bile ducts becoming inflamed and enlarged, blocking the flow of bile into the small intestine for digestion of fats and absorption of vitamins. This results in the yellow pigment of bile seeping into the blood stream, causing the yellowing of the skin and eyes. In the 80 percent of the cases where there is no virus identified as the cause, a liver biopsy is performed, where a small piece of the liver is taken out of the child with a needle and examined with a microscope.

The biopsy will often show that four or five liver cells are combined into a large cell that still functions, but not as well as a normal liver cell. This type of neonatal hepatitis is sometimes called "giant cell hepatitis."

The symptoms of neonatal hepatitis are similar to another infant liver disease, biliary atresia, in which the bile ducts are destroyed for reasons that are not understood. The infant with biliary atresia is also jaundiced and has an enlarged liver, but is growing well and does not have an enlarged spleen. These symptoms, along with a liver biopsy and blood tests, are needed to distinguish biliary atresia from neonatal hepatitis.

Complications

Patients with neonatal hepatitis caused by rubella or cytomegalovirus are at risk of developing an infection of the brain that could lead to mental retardation or cerebral palsy. Many of these infants will also have permanent liver disease from the destruction of liver cells and the resulting scarring (cirrhosis).

Infants with giant cell hepatitis usually recover (80 percent of cases) with little or no scarring to their liver. Their growth pattern resumes as bile flows normally into the small intestine for digestion and to absorb vitamins.

About 20 percent of the infants with neonatal giant cell hepatitis develop chronic liver disease and cirrhosis. Their liver becomes very hard, due to the scarring, and the jaundice does not disappear by six months of age. Infants who reach this point in the disease eventually will require a liver transplant.

Because of the blockage of the bile ducts and the damage caused to liver cells, infants with chronic neonatal hepatitis will not be able to digest fats and will not be able to absorb vitamins A, D, E and K. The lack of vitamin D leads to poor bone and cartilage development (rickets). Vitamin A is also needed for normal growth and good vision. Vitamin K deficiency is associated with easy bruising and a tendency to bleed, whereas the lack of vitamin E results in poor coordination.

Chronic neonatal hepatitis will lead to the inability of the liver to eliminate toxins in the bile. This causes itching, skin eruptions and irritability.

Treatment

There is no specific treatment for neonatal hepatitis. Vitamin supplements are usually prescribed and many infants are given phenobarbital, a drug used to control seizures, but which also stimulates the liver to excrete additional bile. Formulas containing more easily digested fats are also given to the infant.

Neonatal hepatitis caused by the hepatitis A virus also usually resolves itself within six months, but cases that are the result of infection with the hepatitis B or hepatitis C viruses most likely will result in chronic liver disease. Infants who develop cirrhosis ultimately will need a liver transplant.

Risk of Contagion

Infants with neonatal hepatitis caused by the cytomegalovirus, rubella or the hepatitis A, B, and C viruses may transmit the infection to others who come in close contact with the infant.

These infected infants should not come into contact with pregnant women because of the possibility that the woman will transmit the virus to her unborn child.

UpToDate Contents

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English Journal

Hepatitis B virus surface antibody titers in babies administered hepatitis B immune globulin both intravenously and intramuscularly after birth.

Hanaoka M1, Hisano M1, Hama I1, Tsukamoto K1, Ito R2, Ito Y1, Sago H1, Matsui A2, Yamaguchi K1.
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.J Matern Fetal Neonatal Med.2016 Jun;29(12):1945-8. doi: 10.3109/14767058.2015.1069270. Epub 2015 Sep 28.
OBJECTIVE: High rates of vertical transmission of hepatitis B virus (HBV) infection from carrier mothers to their babies are observed in hepatitis B e antigen (HBeAg)-positive mothers under the existing protocol. The current status suggests that the existing protocol may be insufficient for the prev
PMID 26414100

Maternal hepatitis B virus carrier status and pregnancy outcomes: a prospective cohort study.

Cui AM1, Cheng XY1, Shao JG2, Li HB3, Wang XL4, Shen Y4, Mao LJ1, Zhang S4, Liu HY1, Zhang L5, Qin G6,7.
BMC pregnancy and childbirth.BMC Pregnancy Childbirth.2016 Apr 26;16(1):87. doi: 10.1186/s12884-016-0884-1.
BACKGROUND: Infection with hepatitis B virus (HBV) in pregnant women may be a threat for both mothers and fetuses. This study was performed to explore the impact of maternal HBV carrier status on pregnancy outcomes.METHODS: We conducted a prospective cohort study at the Obstetrics & Gynecology H
PMID 27113723

The immunogenicity in healthy infants and efficiency to prevent mother to child transmission of Hepatitis B virus of a 10μg recombinant yeast-derived Hepatitis B vaccine (Hep-KSC).

Zhu FC1, Sun KX2, Pan HX1, Yang ZH3, Lu Y2, Liang ZL4, Liang XF5, Wang FZ5, Zeng Y6, Li J7.
Vaccine.Vaccine.2016 Apr 23. pii: S0264-410X(16)30196-7. doi: 10.1016/j.vaccine.2016.04.042. [Epub ahead of print]
BACKGROUND AND AIMS: To evaluate immunogenicity and efficacy of a 10μg recombinant Saccharomyces cerevisiae-derived hepatitis B vaccine (Kangtai Biological Products Co. Ltd, Shenzhen, China) (Hep-KSC) in newborns.METHODS: Overall 1197 infants born to mothers negative for HBV markers (NM group) and
PMID 27113166

Japanese Journal

Splenectomy prolongs the effects of corticosteroids in mouse models of autoimmune hepatitis.

Maruoka Ryutaro,Aoki Nobuhiro,Kido Masahiro,Iwamoto Satoru,Nishiura Hisayo,Ikeda Aki,Chiba Tsutomu,Watanabe Norihiko
Gastroenterology 145(1), 209-220.e9, 2013-07
… [Background & Aims]Most patients with autoimmune hepatitis (AIH) initially respond to treatment with corticosteroids but often experience a relapse after treatment is withdrawn. … Neonatal C57BL/6 PD-1^{–/–} mice underwent thymectomy to create a model of chronic AIH. … Neonatal C57BL/6 PD-1^{–/–} mice that underwent thymectomy developed chronic hepatitis with fibrosis and hypergammaglobulinemia and produced antinuclear antibodies; …
NAID 120005315980

Patient with neonatal-onset chronic hepatitis presenting with mevalonate kinase deficiency with a novel MVK gene mutation

TAHARA Masahiro,SAKAI Hidemasa,NISHIKOMORI Ryuta,YASUMI Takahiro,HEIKE Toshio,NAGATA Ikuo,INUI Ayano,FUJISAWA Tomoo,SHIGEMATSU Yosuke,NISHIJIMA Koji,KUWAKADO Katsuji,WATABE Shinichi,KAMEYAMA Junji
Modern rheumatology 21(6), 641-645, 2011-12-01
NAID 10030206205