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Gestational Alloimune Liver Disease—Case Report
We describe the case of a newborn with the antenatal onset of hepatic failure, which has been investigated for all etiologies that can cause liver damage: infectious, metabolic, genetic, and immune. The lack of a clear answer regarding the etiology and the response to immunoglobulin therapy led us t...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9857314/ https://www.ncbi.nlm.nih.gov/pubmed/36670617 http://dx.doi.org/10.3390/children10010066 |
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author | Demetrian, Mihaela Botezatu, Radu Gică, Nicolae Safta, Valentina Grecu, Georgeta Dima, Vlad Binișor, Andreea Daniela Panaitescu, Anca |
author_facet | Demetrian, Mihaela Botezatu, Radu Gică, Nicolae Safta, Valentina Grecu, Georgeta Dima, Vlad Binișor, Andreea Daniela Panaitescu, Anca |
author_sort | Demetrian, Mihaela |
collection | PubMed |
description | We describe the case of a newborn with the antenatal onset of hepatic failure, which has been investigated for all etiologies that can cause liver damage: infectious, metabolic, genetic, and immune. The lack of a clear answer regarding the etiology and the response to immunoglobulin therapy led us to the diagnosis of gestational alloimmune liver disease. Gestational alloimunne liver disease is an uncommon and very severe cause of neonatal acute liver failure (NALF). Initially, the therapeutic approach aimed at correcting the effects produced by iron loading, respectively, iron chelators and antioxidants. Since all aspects of this case indicated characteristic features typical for GALD, therapy with intravenous immunoglobulins (IVIG) was introduced. If such therapy alters the prognosis of newborns with GALD, the etiology and pathophysiology remain uncertain. However, in cases regarding severe hepatic failure with the perinatal onset and apparently unknown etiology, immunoglobulin or exchange transfusion therapy should be taken into account even before finalizing all the etiological investigations. The prognosis is uncertain and varies between clinical resolution, chronic hepatitis/cirrhosis, and the need for a hepatic transplant, and overall survival depends on prompt therapeutic intervention. |
format | Online Article Text |
id | pubmed-9857314 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-98573142023-01-21 Gestational Alloimune Liver Disease—Case Report Demetrian, Mihaela Botezatu, Radu Gică, Nicolae Safta, Valentina Grecu, Georgeta Dima, Vlad Binișor, Andreea Daniela Panaitescu, Anca Children (Basel) Case Report We describe the case of a newborn with the antenatal onset of hepatic failure, which has been investigated for all etiologies that can cause liver damage: infectious, metabolic, genetic, and immune. The lack of a clear answer regarding the etiology and the response to immunoglobulin therapy led us to the diagnosis of gestational alloimmune liver disease. Gestational alloimunne liver disease is an uncommon and very severe cause of neonatal acute liver failure (NALF). Initially, the therapeutic approach aimed at correcting the effects produced by iron loading, respectively, iron chelators and antioxidants. Since all aspects of this case indicated characteristic features typical for GALD, therapy with intravenous immunoglobulins (IVIG) was introduced. If such therapy alters the prognosis of newborns with GALD, the etiology and pathophysiology remain uncertain. However, in cases regarding severe hepatic failure with the perinatal onset and apparently unknown etiology, immunoglobulin or exchange transfusion therapy should be taken into account even before finalizing all the etiological investigations. The prognosis is uncertain and varies between clinical resolution, chronic hepatitis/cirrhosis, and the need for a hepatic transplant, and overall survival depends on prompt therapeutic intervention. MDPI 2022-12-28 /pmc/articles/PMC9857314/ /pubmed/36670617 http://dx.doi.org/10.3390/children10010066 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Demetrian, Mihaela Botezatu, Radu Gică, Nicolae Safta, Valentina Grecu, Georgeta Dima, Vlad Binișor, Andreea Daniela Panaitescu, Anca Gestational Alloimune Liver Disease—Case Report |
title | Gestational Alloimune Liver Disease—Case Report |
title_full | Gestational Alloimune Liver Disease—Case Report |
title_fullStr | Gestational Alloimune Liver Disease—Case Report |
title_full_unstemmed | Gestational Alloimune Liver Disease—Case Report |
title_short | Gestational Alloimune Liver Disease—Case Report |
title_sort | gestational alloimune liver disease—case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9857314/ https://www.ncbi.nlm.nih.gov/pubmed/36670617 http://dx.doi.org/10.3390/children10010066 |
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