Abstract Ref Number = APCP877
INTRACRANIAL BLEEDING IN INTRAHEPATIC CHOLESTASIS DUE TO CYTOMEGALOVIRUS INFECTION
ASRUL SALAM,SETIA BUDI SALEKEDE,HERRY D NAWING,HADIA ANGGRIANI
DEPARTEMEN ILMU KESEHATAN ANAK FK UNHAS
Background : Intrahepatic cholestasis is a clinical syndrome arise from inhibition of secretions and or bile flow occurring in the liver. Clinically, cholestasis is characterized by jaundice, pale or acholic stools, and dark-tea coloured urine, bleeding is due to vitamin K deficiency, pruritus, failure to thrive. Intrahepatic cholestasis in infants can be caused by several conditions, cytomegalovirus (CMV) infection is one of the most common causes.
Case Presentation Summary : Infants aged 2 months 20 days was hospitalized with decreased of consciousness since 4 days before. There was yellow all over the body since the age of 10 days. There are sometimes acholic stool. From physical examination there was decrease in consciousness with GCS 10, jaundice, there was bulging fontanella. From the laboratory examination: show increase in PT and APTT, IgM and IgM anti CMV was positive. CT Scan examination show intracranial bleeding accompanied by subfalcine herniation and cerebral edema. After treated with antibiotics, dexamethasone, ursodeoxycholic acid, ganciclovir, the condition improved before discharged.
Learning Points/Discussion : - Bleeding is one of the symptoms of cholestasis could occur due to vitamin K deficiency. - Vitamin K supplementation need to be given to cholestasis patients to prevent the bleeding symptoms.
Keywords: INTRACRANIAL BLEEDING INTRAHEPATIC CHOLESTASIS CYTOMEGALOVIRUS INFECTION