TABLE 10-8.

NEONATAL CAUSES OF ACUTE LIVER FAILURE AND DIAGNOSTIC TESTS

DISEASE

DIAGNOSTIC FINDINGS

Galactosemia Tyrosinemia Neonatal hemochromatosis Hemophagocytic lymphohistiocytosis and congenital leukemia Sepsis, shock Giant cell hepatitis with hemolytic anemia HHV-6, Hepatitis b, adenovirus, parvovirus Mitochondrial hepatopathy Vascular malformations and congenital heart disease Maternal overdose Hypocortisolism

Red cell galactose-1-phosphate uridyl transferase Urine succinyl acetone Elevated ferritin, extrahepatic iron deposition Bone marrow findings Positive blood cultures Coombs-positive hemolytic anemia Viral serology and polymerase chain reaction Mitochondrial DNA, muscle and/or liver biopsy for quantitative respiratory chain enzymes Echocardiography History, toxicology screen Cortisol levels, ACTH stimulation test

ACTH, Adrenocorticotropic hormone; HHV-6, human herpesvirus 6.