Neonatal Cholestasis: Conjugated Hyperbilirubinemia
Jaundice during the first few weeks of life is a common finding. Frequently, such jaundice is due to elevation of the unconjugated, or indirect, bilirubin and is often the result of a benign process. More concerning is jaundice due to elevation of the conjugated bilirubin fraction. Neonatal cholestasis is defined as an accumulation of biliary substances, such as bilirubin and bile acids because of impaired canalicular bile flow. Neonatal cholestasis manifests with a conjugated hyperbilirubinemia and must be differentiated from unconjugated hyperbilirubinemia, as it is more often associated with a specific disease process. The incidence of neonatal cholestasis has been estimated at 1 in 2,500 live births.
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