Neonatal cholestasis refers to elevated levels of conjugated bilirubin identified in newborn infants within the first few months of life.
However, the underlying disease pathology is caused by improper transport and/or defects in excretion of bile from hepatocytes leading to an accumulation of conjugated bilirubin in the body.
However, most infants affected will present with jaundice, scleral icterus, failure to thrive, acholic or pale stools, and dark urine.
[3] While neonatal cholestasis refers to conjugated hyperbilirubinemia in newborn infants, there are many pathologic processes that can cause this to occur.
Any anatomic disturbance or obstruction in the hepatobiliary tract can cause elevated levels of conjugated bilirubin.
[1] Some of the causes of neonatal cholestasis are listed below: Bilirubin is formed from two sources: hemoglobin in red blood cells and heme-containing proteins in other tissues of the body.
[3] Most infants affected by neonatal cholestasis will present with jaundice, scleral icterus, failure to thrive after two weeks, acholic/pale stools, and dark urine.
[9] If neonatal cholestasis is suspected or an infant is presenting with jaundice after two weeks of life, total and conjugated bilirubin must be measured.
[4] Liver biopsy performed through the skin can be completed if initial evaluation does not indicate neonatal cholestasis but is clinically suspected.