Does thyroid function disorder play a vital role 
in the pathogenesis of neonatal cholestasis?

Salma Nagi; Mai Elashmawy; Mohamed Zaeim Hafez Ahmed; Mahmoud Azab; Ashraf Emara; Osama Abdelhay; Mohamed Doma; Ahmad Awad; Ahmed Saba; Tarek Shikhon; Hesham Ahmed; Ahmed Allah; Marwa Fekry Hassan; Shymaa Khalifa

doi:10.5114/ceh.2025.154503

eISSN: 2449-8238
ISSN: 2392-1099

Clinical and Experimental Hepatology

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abstract:

Original paper

Does thyroid function disorder play a vital role in the pathogenesis of neonatal cholestasis?

Salma Abdel Megeed Nagi

^{1, 2}

,

Mai Ibrahim Elashmawy

³

,

Mohamed Zaeim Hafez Ahmed

⁴

,

Mahmoud Ahmad Mohammed Azab

⁵

,

Ashraf AbdelAty Elshenawy Emara

⁵

,

Osama Mohammad Mohammad Abdelhay

⁵

,

Mohamed AbdelAziz Doma

⁶

,

Ahmad Mohamed Mohamed Awad

⁶

,

Ahmed Mohammed Saba

⁶

,

Tarek Shikhon

⁷

,

Hesham Abdelrahman Mahmoud Ahmed

⁷

,

Ahmed Mohamed Gad Allah

⁸

,

Marwa Fekry Hassan

⁹

,

Shymaa Sobhy Menshawy Khalifa

¹⁰

Faculty of Medicine, King Salman International University, El Tor Branch, South Sinai, Egypt
Pediatric Hepatology, Gastroenterology, and Nutrition department, National Liver Institute, Menoufia University, Shebin El-Kom 32511, Egypt
Clinical Pathology Department, National Liver Institute, Menoufia University, Shebin El-Kom 32511, Egypt
Medical Physiology Department, Faculty of Medicine, Al-Azhar University (Assiut), Assiut, Egypt
Medical Physiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Medical Biochemistry Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Medical Biochemistry Department, Faculty of Medicine, Al-Azhar University (Assiut), Assiut, Egypt
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Al-Azhar University (Assiut), Assiut, Egypt
Epidemiology and Preventive Medicine Department, National Liver Institute, Menoufia University, Shebin El Kom, Menoufia, 6132415, Egypt
Pediatrics Department, Faculty of Medicine, Menoufia University, Shebin El Kom, Menoufia, 6132415, Egypt

Clin Exp HEPATOL 2025; 11, 3: 289–299

DOI: https://doi.org/10.5114/ceh.2025.154503

Online publish date: 2025/09/30

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Introduction
Neonatal cholestasis is a syndrome characterized by decreased bile flow in infants and has several underlying causes, including genetic and metabolic diseases. Thyroid dysfunction may contribute to the pathophysiology of cholestasis, although it is not often acknowledged as a major cause. Further research into this possible connection is necessary because studies have linked thyroid conditions, including hyperthyroidism and euthyroid sick syndrome, to liver damage in newborns. This study aimed to evaluate the thyroid function in infants with neonatal cholestasis and determine whether it has a role in the diagnosis of other causes of neonatal cholestasis.

Material and methods
The study included 100 infants with neonatal cholestasis of different causes (50 infants with biliary atresia [BA] and 50 infants with other causes of neonatal cholestasis other than BA) attending the National Liver Institute, Menoufia University, between July 2024 and January 2025. The infants were evaluated for serum free triiodothyronine (T3), free tetraiodothyronine (T4), and thyroid-stimulating hormone (TSH).

Results
T3 was significantly higher in the non-BA group (3.97 ±0.45) than the BA group (p < 0.0001), while T4 and TSH did not significantly differ among the studied patients (p ≥ 0.05).

Conclusions
The results demonstrated significant differences in T3 levels, with higher levels observed in the non-BA group, while T4 and TSH showed no significant differences between the two groups. These findings suggest that thyroid dysfunction may be associated with neonatal cholestasis, particularly in conditions other than BA.

keywords:

Does thyroid function disorder play a vital role in the pathogenesis of neonatal cholestasis?

biliary atresia, hyperthyroidism, neonatal cholestasis, pathogenesis, thyroid function