Neonatal Cholestasis

Offering providers a vantage point on the many causes and serious consequences of impaired bile flow, this presentation from pediatric gastroenterologist and hepatologist Prita Mohanty, MD, begins with a review of bile acid excretion, then lays out steps for useful categorization and effective evaluation of neonatal cholestasis. Mohanty discusses getting the right lab work at the right time, visualization of urine and stools, and clinical presentations, with a focus on biliary atresia and Alagille syndrome. She explains pros and cons of advanced imaging methods and liver biopsies; the meaning of various biomarkers; and therapeutic approaches, such as the Kasai procedure and IBAT inhibitors for pruritus.

Learning Objectives:

• List the etiologies of neonatal cholestasis.

• Identify the evolving roles of biopsy and gene testing.

• Explain the mode of action and approved indications for ileal bile acid transport (IBAT) inhibitors.