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Karakteristik Klinik dan Laboratorik Kolestasis Intrabepatal dan Ekstrabepatal di Bangsal Perawatan Anak RSU Dr. Saiful Anwar Malang Clinical and laboratory characteristics of intrahepatic and extrahepatic cholestasis in pediatric ward of Dr. Saiful Anwar General Hospital Malang
Introduction: Clinical examination in determining intrahepatic and extrahepatic cholestasis in children and infant remains invasive and difficult. There is a need of simple and aplicative method on clinical practice. The objective of th is review is to find the cause of cholestasis based on clinical and laboratory examination.
Subject and Methode: Sixty nine medical records from pediatric patients who suffered from prolonged conjugated jaundice between January 2008 and March 2011 in the Department of Pediatrics of Dr. Saiful Anwar General Hospital, Malang, lndonesia were reviewed with regard to the clinical examinations, laboratory parameters and ultrasound. Liver ultrasound was used to classify patients into two groups: intra or extrahepatic cholestasis. Unpaired t-test was performed to compare numerical data. P value less than 0.05 were considered as to indicate statistical signijicant.
Results: Leucocytes count (mean 2.649/mm3, 95%CI 1.556 to 12. 141/mm3, p=0.012), ALT (mean 155 IU/L, 95%CI 66.9 to 245 IU/L, p=0.043), cholesterol (mean 243 mg/dl, 95% Cl 31 to 455 mg/dl, p=0.026) and triglyseride (mean 219 mg/dl, 95%CI 40 to 398 mg/dl, p=0.018) were significantly higher in patients with extrahepatic cholestasis than intrahepatic group, but potassium level (mean 1.18 mEq/L, 95% CI 0.22 to 2.14 mEq/L, p=0.017) were signijicantly lower in intrahepatic group. Pale stool color had 75% sensitivity and 80% spesijicity in determining extrahepatic cholestasis.
Conclusion: Elevated leucocyte count, increased ALT serum level, cholesterol, triglyseride and decreased of potassium and acholic stool can be used as determinant factors in classifying intra or extrahepatic cholestasis in children.
Keywords: Acholic stool, leucocyte, ALT, cholesterol, triglyseride, potassium, cholestasis
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