Neonatal cholestasis includes a myriad of disorders characterized by conjugated hyperbilirubinemia with their early recognition being crucial in their treatment and prognosis. The leading cause of neonatal cholestasis is biliary atresia which is the most common indication for pediatric liver transplantation worldwide. During the workup of these patients one of the crucial components is the evaluation of liver biopsies which in the hands of an experienced pathologists has a positive predictive value for biliary atresia of ~90%. The histologic changes in these biopsies can be grouped in three histologic patterns: obstructive, neonatal hepatitis (giant cell hepatitis) and bile duct paucity. Each one of these patterns is associated with several important diagnostic considerations. In this virtual grand round, we will discuss a practical approach to these challenging biopsies with an emphasis in grouping these cases in one of those histologic groups particularly the obstructive pattern given its treatment implications. Faculty/AuthorsIvan Gonzalez, MD Physician Competencies: Medical knowledgeCME/CMLE Credit: 1.0 Estimated Completion Time: 1 hour Format: Online Educational Activity Accreditation Statement: The American Society for Clinical Pathology (ASCP) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education (CME) for physicians. This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME). Credit Designation Statement: The American Society for Clinical Pathology (ASCP) designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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Release Date: 12/04/2024Review Date:Expiration Date: 12/04/2027