A Genetic Study of Neonatal Obstructive Jaundice

Clarification of the problem of jaundice in the neonatal period began with the discovery of foeto- maternal rhesus incompatibility as the usual cause of haemolytic disease of the newborn. After this, the group of infants in whom the jaundice is of obstructive type, with pale stools and bile in the urine, received more attention, and it was soon realized that not all such infants suffered from atresia of the main bile-ducts. In 1952 Craig and Landing described the characteristic histological appearance of the liver in cases with patent bileducts, and the disease has become known as 'neonatal giant cell hepatitis'. Since then various authors have accepted the separation of this disease entity on anatomical and histological grounds, while others have felt that the histological features may be mimicked by other diseases affecting the liver in the foetal or newborn period, of varied causes such as rhesus incompatibility, cytomegalic inclusion cell virus, pyaemic infection or pylephlebitis. It is certainly true that giant cell change may be seen in many of these conditions or in biliary atresia, but consideration of other histological features seems to allow the definition of a group of cases apart from these causes.