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All Journal JOURNAL OF COMMUNITY MEDICINE AND PUBLIC HEALTH RESEARCH
Winahyu, Anindya Kusuma
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Health Professions Medicine & Pharmacology Public Health

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The Successful Administration of Steroid in Extrahepatic Cholestasis Winahyu, Anindya Kusuma; Prihaningtyas, Rendi Aji; Setyoboedi, Bagus; Arief, Sjamsul
Journal of Community Medicine and Public Health Research Vol. 4 No. 2 (2023): Journal Community Medicine and Public Health Research
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jcmphr.v4i2.47751

Abstract

Biliary atresia is the most common cause of liver transplantation in children. Kasai surgery is still a bridging therapy for biliary atresia, but patients are often late for treatment. Based on the currently proposed theory, biliary atresia results from a progressive inflammatory process and progresses to fibrosis of the bile ducts. A case of a 1.5-month-old boy with prolonged jaundice followed by acholic stools and dark urine was presented. He had cholestasis, elevated GGT levels, and a liver biopsy suggesting extrahepatic cholestasis. He was treated with methylprednisolone, ursodeoxycholic acid, and vitamin supplementation was started orally. After steroid therapy, direct bilirubin levels decreased rapidly to 0.55 mg/dl on day 14. Jaundice, acholic stools, cholestasis, and liver function tests were improved. Therapeutic opportunities based on the pathogenesis of inflammation in biliary atresia using steroids may provide new opportunities for non-surgical management of biliary atresia in the early phase of the disease.
Delayed Admission in Neonatal Cholestasis Setyoboedi, Bagus; Prihaningtyas, Rendi Aji; Winahyu, Anindya Kusuma; Arief, Sjamsul
Journal of Community Medicine and Public Health Research Vol. 5 No. 2 (2024): Journal Community Medicine and Public Health Research
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jcmphr.v5i2.47315

Abstract

Delayed diagnosis of cholestasis in neonates remains a problem. Cholestatic jaundice is a pathological condition that requires immediate treatment, such as biliary atresia. This study aims to analyze the characteristics of infants with cholestasis who seek treatment at a tertiary hospital. This study was a cross-sectional study to determine the characteristics of infants with cholestasis treated at the tertiary hospital at Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia. Subjects were collected using medical records using the consecutive method from 2019 to 2021. The inclusion criteria in this study were infants aged >2 weeks who suffered from cholestasis. The age of the 111 infants with cholestasis involved was 4.8 ± 2.9 months old. A total of 27 (24.3%) infants visited the hospital at the age of <2 months, 36 (32.4%) at the age of 2-4 months, but most of them, consisting of 48 (43.2%) infants, came to the hospital at the age of >4 months. Jaundice was present at birth in 23 infants (20.7%), and most infants had jaundice at 1 month of age in 75 infants (67.6%). Most of the infants (75 infants) had jaundice at the age of 1 month but visited the hospital at the age of >4 months. This showed that the late diagnosis of cholestasis in infants was still quite high. This study supports education for early detection of cholestasis in primary healthcare medical personnel, community health workers, and parents.
Co-Authors Bagus Setyoboedi Prihaningtyas, Rendi Aji Sjamsul Arief, Sjamsul