Changes of coagulation inhibitors and fibrinolysis system in newborn infants with transitory neonatal cholestasis.

Introduction: The hemostatic system in newborn is a dynamic evolving process health-status dependent.

Objective: To explore the changes in coagulation inhibitors and fibrinolytic system in newborn with neonatal cholestasis, according liver damage intensity.

Methods: In a cross-sectional design, we studied fibrinolysis and coagulation inhibitor proteins, and serum ferritin (SF) in patients with neonatal cholestasis. We stratified the cases according the results of ALT or AST < 100 UI (group I) and > or =100 U/L (group II).

Results: We included 24 newborn, 8 for Group I and 16 cases for group II. We documented statistical differences in ATIII values (43.4 vs 27.4%, p < 0,01), plasmin inhibitor (93.5 vs 63.6%, p < 0.01), SF (649 vs 1410 ug/L, p 0.01). The group II cases showed association with SF values (f 20.6, p < 0.01) and plasmin inhibitor (f 40.4, p < 0.01). AST and ALT were related significantly to ATIII concentrations and SF.

Discussion: We documented tendency to prothrombotic state (lower ATIII and greater plasmin inhibitor activity), with low plasminogen related to the intensity of liver dysfunction in neonatal cholestasis. We need to determine the role of iron overload in physiopathology of the disease.