Liver injury occurs with many drugs; therefore, a thorough work up is important for establishing the diagnosis. We report a case of trifluoperazine-induced cholestatic jaundice. A 44-year old male with schizoaffective disorder developed an increase in liver enzymes and jaundice after starting treatment with trifluoperazine Workup for other potential etiologies was negative.

Introduction: Urinary tract infections (UTI) are common and serious clinical problems in newborn infants. Previous studies have reported that jaundice may be one of the signs of a UTI in infants. The aim of this study was to evaluate the incidence, age presentation, and severity of jaundice, sign and complications of UTI in newborns with asymptomatic, unexplained indirect hyperbilirubinemia.Methods: This was a cross sectional study conducted between May 2004 and April 2009, at the Neonatal intensive care unit, Ghaem Hospital, Mashhad, Iran. A total of 1487 infants with jaundice were recruited of which 1061 patients were evaluated for UTI. Among them, 629 infants were excluded and remaining 74 patients with UTI and 358 infants with unknown etiology of jaundice without UTI. Demographic data including prenatal, intrapartum, postnatal events and risk factors were collected by questionnaire. Biochemical markers including serum fractionated bilirubin level, urinalysis, and routine laboratory tests were measured. Written informed consent from parents of infants was obtained. The protocol was approved by the Medical Ethics Committee of Mashhad University of Medical Sciences.Results: Age presentation, age admitted to hospital, age of improved jaundice, serum bilirubin level and hospital stay in case group were significantly higher than control groups (p<0.05). UTI was diagnosed in seventy four (6.97%) cases (escherichia coli (44.4%), klebsiella pneumoniae (22%)). Pyuria and or Bacteriuria were present in 58% of patients. Renal ultrasound showed urinary tract abnormalities in Twenty three (23%) patients. Six infants had unilateral grade 1 to 3 reflux in voiding cysto urethrogram (VCUG).Conclusion: UTI was found in 7% of asymptomatic, jaundiced infants. Therefore, we recommend that testing for a UTI be included as part of the evaluation in asymptomatic, jaundiced infants presenting after five day of life.These infants should be evaluated for urinary tract abnormality by renal ultrasound and VCUG.

A middle-aged woman suffering from jaundice and pruritus that had begun a month previously was presented to a physician. At the first assessment, laboratory findings had revealed a cholestatic pattern and serologic tests for hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis A virus (HAV) were negative. Normal findings of abdominal computed tomography (CT) scan and endoscopic retrograde cholangiopancreatography (ERCP) ruled out extrahepatic causes of cholestasis. A liver biopsy was done and showed intrahepatic cholestasis without destruction of the bile ducts or granuloma. We assessed the intrahepatic causes of cholestasis. Finally the diagnosis was confirmed by means of a simple test.

Background: Hyperbilirubinemia is one of the most serious problems encountered in the newborn period. There are many reasons for newborn jaundice etiology. In this study, we aimed to investigate the frequency of subgroup incompatibilities in the etiology of hyperbilirubinemia, its association with blood group incompatibilities and the treatments given. Methods: In this retrospective study, we evaluated 240 newborn patients who were diagnosed as hyperbilirubinemia in Dicle University Faculty of Medicine Neonatal Unit between January 2016 and June 2017. Results: Subgroup incompatibility was detected in 32% of cases. Only 35. 4% of cases with subgroup incompatibility were found just subgroup incompatible. Subgroup C incompatibility was found in 43%, Rh incompatibility in 35% and subgroup E incompatibility in 33% of cases. Direct Coombs Test positivity was detected in 38% of cases. Blood exchange procedure was performed in 16. 5% of cases with subgroup incompatibility. Blood exchange was applied to 40. 9% of those with Rh and C incompatibility. Only 50% of those with Rh and C subgroup incompatibility were applied blood exchange (this group was not accompanied by Rh or ABO incompatibility). Intravenous immunoglobulin treatment was given in 24. 1% of cases with subgroup incompatibility in total. Intravenous immunoglobulin treatment was given also to 17. 85% of cases with only subgroup incompatibility that did not accompany Rh and ABO incompatibility. Conclusion: Detection of subgroup blood incompatibilities in cases with neonatal jaundice is important in diagnosis, treatment and follow-up.