Prolonged Obstructive Jaundice in Infants: "Steroid Test" for the Differential Diagnosis of Neonatal Hepatitis and Biliary Atresia

The differential diagnosis of neonatal hepatitis and biliary atresia is still an unsolved problem in pediatric practice. The conventional methods used for evaluation are usually unable to differentiate these two hepatobiliary diseases. Corticosteroids have been used as an aid in the differential diagnosis of neonatal jaundice. Yet there are no definite criteria to follow in making surgical indication in the early stage. In this study, a procedure employing prednisolone in a dosage of 2mg/kg/day as a diagnostic agent in an attempt to differentiate the neonatal hepatitis from biliary atresia was named ”Steroid test”. This test proved to be highly sensitive and specific in differentiating these two diseases within a two-week period and also simple, inexpensive and free from complications. Because ”Steroid test” can be performed at private clinics also as a home treatment, many sophisticated laboratory examinations and unnecessary hospitalization can thus be avoided.