Presentation
Eleven neonates who presented with suspected neonatal liver failure were included in the study. The sex, gestational age, and presenting signs and symptoms are listed in Table 1. Patients 6 and 7 were siblings. [jamanetwork.com]
At present, there is no effective approach to prenatal diagnosis. Case Report: A 23-year-old pregnant woman presented at 32 weeks of gestation with oligohydramnios and hyperechogenic liver focus on ultrasound. [revistas.rcaap.pt]
Scarring from macrophages, which contain high levels of stainable iron, may be present. [emedicine.medscape.com]
Clinical findings GALD can present anytime from 18 weeks gestation to 3 months post-delivery. The majority of infants present with liver failure within hours of birth. [ncbi.nlm.nih.gov]
Summary Neonatal hemochromatosis (NH) is a very rare disease, although a common cause of neonatal liver failure.We present a newborn with severe liver failure and renal dysfunction, who died due to cardio-respiratory insufficiency. [link.springer.com]
Workup
Other Pathologies
- Hepatic Necrosis
The autopsy of the fifth patient who died (patient 9), whose antemortem lip specimen had been negative, demonstrated massive hepatic necrosis suggestive of a viral cause and no evidence of NH. [jamanetwork.com]
Treatment
The purpose of treatment is to limit the elaboration of immunoglobulin (mother's immune attack) directed against the fetus (baby). [luriechildrens.org]
Standard Therapies Treatment The treatment of neonatal hemochromatosis is controversial. [rarediseases.org]
[citation needed] Treatment[edit] Effective treatment of the disease has been confined to liver transplants. Success has also been reported with an antioxidant chelation cocktail, though its effectiveness cannot be confirmed. [en.wikipedia.org]
Second, medical treatment must be initiated as soon as possible to stabilize the patient and allow for liver transplantation.2-4 Occasionally, medical treatment is successful in its own right. [jamanetwork.com]
Prognosis
Establishment of the diagnosis in an affected fetus or newborn may have a major impact for the prognosis of disease and for the outcome of future pregnancies. Downloads Download data is not yet available. [revistas.rcaap.pt]
The prognosis is extremely poor. Some infants recover with supportive care, but this rarely occurs. Suggest genetic counseling if the parents of a child with neonatal hemochromatosis desire to have another child. [emedicine.medscape.com]
First, prognosis is invariably fatal without aggressive medical therapy and/or a liver transplant, and the management plan must be established early. [jamanetwork.com]
Treatment Literature suggests that the prognosis for severe NH without intervention is very poor. [ncbi.nlm.nih.gov]
Etiology
Neonatal hemochromatosis is not a single disorder but is a syndrome with an unclear etiology. [emedicine.medscape.com]
The medication is benign and a single dose poses little risk to the newborn, regardless of disease etiology. [ncbi.nlm.nih.gov]
Epidemiology
Epidemiology Neonatal hemochromatosis is rare. [6] To date, no rates of this disease are reported. Studies suggest a genetic prevalence of 0.03-0.038 or a heterozygosity prevalence of 6-7%. [emedicine.medscape.com]
Retrospective epidemiological study of Latin American patients with transfusional hemosiderosis: the first Latin American epidemiological study in iron overload--the RELATH study. [medicinaylaboratorio.com]
Hypoparathyroidism in the adult: epidemiology, diagnosis, pathophysiology, target-organ involvement, treatment, and challenges for future research. J Bone Miner Res. 2011;26(10):2317–37. DOI : 10.1002/jbmr.483. [ncbi.nlm.nih.gov]
Pathophysiology
Hypoparathyroidism in the adult: epidemiology, diagnosis, pathophysiology, target-organ involvement, treatment, and challenges for future research. J Bone Miner Res. 2011;26(10):2317–37. DOI : 10.1002/jbmr.483. [ncbi.nlm.nih.gov]
Pathophysiology In hemochromatosis, hepatocytes are the first site of iron deposition. Liver tissue of affected infants displays severe injury with marked loss of hepatocytes. [emedicine.medscape.com]
In: Kleinman RE, Goulet O-J, Sherman PM, Sanderson IR, Shneider BL, Walker WA, eds, Walker’s Pediatric Gastrointestinal Disease: Pathophysiology, Diagnosis, Management. 5th ed. Hamilton, Ontario: BC Decker; 2008:1049-56. [rarediseases.org]
In: Sleisenger and Fordtran's Gastrointestinal and liver disease pathophysiology diagnosis management, edited by Feldman M, Friedman LS, Brandt LJ. Philadelphia: Saunders Elsevier, 2016, p. 1409-1427. [medicinaylaboratorio.com]
Prevention
These findings suggest that a simple therapy might prevent this devastating disease. Further study is underway to confirm these results. [luriechildrens.org]
The most promising treatments are then moved into clinical trials, with the goal of identifying new ways to safely and effectively prevent, screen for, diagnose, or treat a disease. [liverfoundation.org]
The discovery of the alloimmune etiology of NH has impacted approaches to its diagnosis, treatment, and prevention. [ncbi.nlm.nih.gov]
Therapy aimed at preventing neonatal hemochromatosis before it occurs has proven very effective. [rarediseases.org]
Neonatal hemochromatosis: Management, outcome, and prevention. Prenatal Diagnosis. 2013;33(13):1221-1225. doi:10.1002/pd.4232 Whitington, PF., Pan, X., Kelly, S., Melin-Aldana, H., Malladi, P. [ojs.actapediatrica.org.mx]