Prognosis of babies with neonatal hepatitis

Abstract

105 babies with neonatal hepatitis were studied carefully and followed for up to 11.5 years. Ascertainment was complete for those with severe and persistent jaundice, but less complete for mild or anicteric cases. Prognosis was found to be poor (40% death or cirrhosis) in babies with persistently acholic stools, but relatively good (<15% death or cirrhosis) in those with jaundice which was less persistent and less obstructive. The presence of second diseases (including α1 antitrypsin deficiency or a family history of other affected children) seemed to play a part in determining poor prognosis. A distinctive group of babies (22 cases) presented with acute fulminant illness (with or without jaundice) in the neonatal period. Cytomegalovirus infection carried a relatively good prognosis. Guidelines for selection of patients for therapeutic trials are suggested.