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Etiology of Kotb Disease Biliary Atresia Variant in Neonates. (a) Pregnant mother heterozygous for Glutathione S-transferase M1, and her fetus is homozygous Glutathione S-transferase M1 deficient; (b) After delivery the undetoxified maternally ingested aflatoxins B1 and B2 will accumulate in the liver of the baby and initiate a massive immune response that ends in obliterative adhesions and fibrosis of extrahepatic bile ducts.
