Hepatitis is an inflammation of the liver that can be caused by numerous viruses, diseases or environmental conditions that cause the liver to become inflamed. When hepatitis occurs in infancy, this is called “neonatal hepatitis”.
Twenty percent of neonatal hepatitis is caused by a virus that was passed from mother to child either before birth or shortly thereafter. In eighty percent of the cases of hepatitis medical experts are unable to determine the exact cause; however, it is suspected that these cases were also caused from some type of viral infection.
Viruses that Cause Neonatal Hepatitis
“Cytomegalovirus” or “CMV” is one of the viruses that are responsible for causing neonatal hepatitis in some infants and is the most common type of virus that is passed on from a mother to their unborn child during pregnancy. Other viruses that can be passed from mother to child during pregnancy causing neonatal hepatitis include, measles (rubella), and hepatitis viruses including A, B, or C.
In many cases of hepatitis when the exact cause is undetermined, a biopsy of the liver will be done. This biopsy will often show the presence of “giant cell hepatitis” which is characterized by four of five normal cells of the liver combining to form one cell that is still functional, however, it does not perform as well as the normal smaller liver cells.
Symptoms and Complications that can occur with Neonatal Hepatitis
The primary symptom that occurs when an infant has neonatal hepatitis is jaundice which causes the skin and the whites of the eyes to become a yellowish color. This condition is caused by the bile ducts of the liver becoming inflamed or swollen blocking the flow of bile to the digestive system causing it to become backed up and enter the blood stream.
For this reason, neonatal hepatitis causes some of the same or very similar symptoms to another liver disease that is primarily seen in infants called “biliary atresia”, however, the spleen will become enlarged in neonatal hepatitis but typically will not with biliaty atresia. This symptom of an enlarged spleen and laboratory tests including a liver biopsy is what is used to determine and confirm a diagnosis of these diseases as opposed to biliary atresia.
Infants with neonatal hepatitis will also have a delay in growth and will not gain weight at a normal rate due to the fact that they are unable to absorb the necessary vitamins and nutrients needed for growth.
Most infants will recover from giant cell hepatitis and may have little or no scar tissue develop on the liver; however, about twenty percent of infants who have giant cell hepatitis will develop liver disease that is chronic causing permanent damage to the liver by the formation of scar tissue and will require a liver transplant at some point in time. In cases where the neonatal hepatitis was caused by the viruses cytomegalovirus or rubella, there is the potential for an infection to occur in the brain that may cause cerebral palsy or mental retardation.
Treatment for Neonatal Hepatitis
In infants who have developed neonatal hepatitis due to the hepatitis A virus, this condition will typically clear on its own within a six month period of time, however, when the hepatitis is caused by the hepatitis B and C viruses, this will likely cause liver disease that is chronic resulting in cirrhosis that will require a liver transplant in the future.
Infants will typically be prescribed vitamin supplements and phenobarbital that will increase the production of bile within the liver as well as a special formula that contains fats that are easier to digest.
There is the potential for infants who have developed neonatal hepatitis due to the A, B, or C hepatitis viruses, rubella, or CMV to pass this virus to others. It is essential for pregnant women to avoid coming into contact with an infant who is infected as there is the potential that they may pass this virus to there unborn child.