Please Help!

I have a 4 day old neice who is currently being hospitalized with jaundice, an enlarged liver, bleeding, and her body isnt producing enough platelets. The Doctors there are trying to figure out what is going on with her but she is going through liver failure and time is of the essence. Are there any ideas that you would have that could be able to help? There is no family history of any metabloic disorders and she has been in the hospital since her birth.

Thank You

[Yao Sun, MD, PhD]

Liver failure in the newborn period can have many causes, including infection by either bacteria or viruses (enterovirus and herpes simplex being the most common viral causes), inborn errors of metabolism (galactosemia, organic acidemias, amino acidemia, storage disorders, bile acid disorder), hemochromatosis (iron storage disorder), and drug toxicity.  This list is not exhaustive.

The evaluation for any of these disorders depends upon the history of the current illness as well as the physical exam, laboratory, and imaging studies that are first obtained.  The progress of the disease as well as the current findings help the healthcare team decide how to proceed given the many possible pathways that can be pursued.

The parents should have open discussions with the Neonatologist or Pediatrician about what the baby's current status and how the healthcare team plans to proceed.