The changing pattern of diagnosis of infantile cholestasis

Objective: Cholestatic liver disease in infancy is caused by a wide range o f conditions. This study reviews the pattern of diagnosis of infants with c holestasis presenting to a tertiary referral paediatric hospital in Sydney, Australia, during a 12-year period (1985-96). Methodology: Infants aged less than 6 months with cholestasis were identifi ed retrospectively from hospital records and data retrieved from the medica l records. Results: There were 205 infants identified as having cholestatic liver dise ase. The aetiology of the cholestasis was idiopathic in 25%, metabolic/gene tic in 23%, and due to obstruction in 20%, parenteral nutrition in 20%, inf ection in 9% and bile duct hypoplasia in 3%. Conclusions: This study highlights the changing patterns of diagnosis of ch olestatic liver disease in infants at a tertiary paediatric facility, demon strating that up to 50% of cases are now due to genetic/metabolic diseases or parenteral nutrition, and a high proportion are due to idiopathic diseas e.