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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...

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Autores principales: Demetrian, Mihaela, Botezatu, Radu, Gică, Nicolae, Safta, Valentina, Grecu, Georgeta, Dima, Vlad, Binișor, Andreea Daniela, Panaitescu, Anca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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.
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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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