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All Journal Archives of Pediatric Gastroenterology, Hepatology, and Nutrition JUKEJ: Jurnal Kesehatan Jompa
Hartaman Putra, Hisyam
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Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Impact of Biliary Atresia on Neurodevelopment in Children: A Systematic Review Hartaman Putra, Hisyam; Permata Putri, Vanessa; Nafisyah, Sri Wahyuni Evi; Luthfi, Mishbakhul; Nur Ilhami, Rahmat Hidayat; Basuki, Siswanto
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 5 No. 1 (2026): APGHN Vol. 5 No. 1 February 2026
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.5.1.2026.1-17

Abstract

Background: Survival in children with biliary atresia (BA) has improved substantially, shifting clinical focus toward long-term morbidity, including neurodevelopmental outcomes. However, existing evidence remains fragmented, and prior reviews have not comprehensively addressed motor, behavioral, and autism-related domains. This study aimed to synthesize current evidence on neurodevelopmental outcomes in children with BA across cognitive, motor, and behavioral domains, and to identify clinical factors associated with adverse developmental trajectories. Methods: A systematic search of PubMed, Scopus, and Wiley was conducted from database inception to October 17, 2025, following PRISMA 2020 guidelines. Observational studies reporting neurodevelopmental outcomes in children (≤18 years) with BA were included. Risk of bias was assessed using the Newcastle–Ottawa Scale and the Joanna Briggs Institute checklist. Due to substantial heterogeneity, a narrative synthesis was performed. Result: Seven studies involving infants to adolescents with BA were included. Motor impairment was the most consistent finding, detectable from early infancy and persisting into later childhood. Cognitive outcomes were heterogeneous, ranging from significant impairment to age-appropriate or above-normative performance in selected cohorts. Behavioral and adaptive difficulties, including attention problems and autism spectrum–related traits, were frequently reported. Markers of disease severity such as unsuccessful Kasai portoenterostomy (KPE), delayed jaundice clearance, growth failure, ascites, and portal hypertension were consistently associated with poorer neurodevelopmental outcomes. Conclusion: Children with BA are at increased risk of multidimensional neurodevelopmental impairment, particularly affecting motor and behavioral domains. Early identification and longitudinal neurodevelopmental surveillance are essential to optimize long-term functional outcomes in this vulnerable population.
Faktor Risiko dan Luaran Klinis Hiperglikemia pada Anak dengan Leukemia Limfoblastik Akut Selama Fase Induksi Kemoterapi: Tinjauan Naratif Hartaman Putra, Hisyam; Luthfi, Mishbakhul; Ad-Dimasyqi, Naravitto; Delfina Andreza, Tasya; Djumain , Rahmadina
JUKEJ : Jurnal Kesehatan Jompa Vol 5 No 1 (2026): JUKEJ: Jurnal Kesehatan Jompa
Publisher : Yayasan Jompa Research and Development

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57218/jkj.Vol5.Iss1.2319

Abstract

Hiperglikemia merupakan komplikasi metabolik yang sering terjadi selama fase induksi kemoterapi pada anak dengan Leukemia Limfoblastik Akut (LLA), yang terutama berkaitan dengan efek diabetogenik kortikosteroid dan asparaginase. Pemahaman mengenai faktor-faktor yang memengaruhinya penting untuk deteksi dini, pencegahan komplikasi, dan optimalisasi luaran terapi. Tinjauan ini merupakan narrative review yang merangkum bukti dari uji klinis dan studi observasional pada pasien anak (0–18 tahun) dengan LLA selama fase induksi. Pencarian literatur dilakukan melalui PubMed, Scopus, Ovid, Wiley, dan Google Scholar menggunakan kata kunci terkait LLA, terapi induksi, hiperglikemia, dan faktor risiko. Artikel full-text yang melaporkan kejadian atau faktor penentu hiperglikemia diikutsertakan dalam analisis. Sebanyak sembilan studi memenuhi kriteria inklusi, dengan prevalensi hiperglikemia yang dilaporkan berkisar antara 7% hingga 52%. Faktor risiko yang paling menonjol adalah usia >10 tahun, terutama pada masa pubertas akibat resistensi insulin fisiologis. Faktor lain yang turut berkontribusi meliputi overweight atau obesitas, riwayat keluarga diabetes melitus, serta Down syndrome. Faktor terkait terapi, khususnya penggunaan kortikosteroid dan native L-asparaginase, juga berhubungan dengan peningkatan risiko. Hiperglikemia dikaitkan dengan peningkatan angka infeksi dan luaran terapi yang lebih buruk. Oleh karena itu, identifikasi dini pasien berisiko tinggi serta pemantauan glukosa yang lebih ketat penting dilakukan untuk meningkatkan luaran klinis.
Co-Authors Ad-Dimasyqi, Naravitto Basuki, Siswanto Delfina Andreza, Tasya Djumain , Rahmadina Luthfi, Mishbakhul Nafisyah, Sri Wahyuni Evi Nur Ilhami, Rahmat Hidayat Permata Putri, Vanessa