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Gestational Alloimmune Liver Disease
Roya Sohaey, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Gestational alloimmune liver disease (GALD)
              • Definitions

                • Neonatal hemochromatosis (NH): Liver injury associated with hepatic and extrahepatic iron overload, which spares reticuloendothelial system
                  • NH is phenotype with several causes
                  • GALD is most common cause of NH and neonatal liver failure (NLF) (> 95%)
                  • Other causes of NH (< 5%): Infection, metabolic disorder, inborn errors of bile-acid synthesis, other
                • GALD: Maternal-fetal immunoglobulin G (IgG)-mediated alloimmune disorder directed at fetal liver
                • Siderosis: Deposition of excess iron in tissue

              IMAGING

              • General Features

                • Ultrasonographic Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Jensen KK et al: Fetal hepatomegaly: causes and associations. Radiographics. 40(2):589-604, 2020
                                        2. Larson-Nath C et al: Neonatal acute liver failure. Clin Perinatol. 47(1):25-39, 2020
                                        3. Sciard C et al: Prenatal imaging features suggestive of liver gestational allo immune disease. J Gynecol Obstet Hum Reprod. 48(1):61-4, 2019
                                        4. Taylor SA et al: The effects of gestational alloimmune liver disease on fetal and infant morbidity and mortality. J Pediatr. 196:123-8.e1, 2018
                                        5. Heissat S et al: Neonatal hemochromatosis: diagnostic work-up based on a series of 56 cases of fetal death and neonatal liver failure. J Pediatr. 166(1):66-73, 2015
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Gestational alloimmune liver disease (GALD)
                                                    • Definitions

                                                      • Neonatal hemochromatosis (NH): Liver injury associated with hepatic and extrahepatic iron overload, which spares reticuloendothelial system
                                                        • NH is phenotype with several causes
                                                        • GALD is most common cause of NH and neonatal liver failure (NLF) (> 95%)
                                                        • Other causes of NH (< 5%): Infection, metabolic disorder, inborn errors of bile-acid synthesis, other
                                                      • GALD: Maternal-fetal immunoglobulin G (IgG)-mediated alloimmune disorder directed at fetal liver
                                                      • Siderosis: Deposition of excess iron in tissue

                                                    IMAGING

                                                    • General Features

                                                      • Ultrasonographic Findings

                                                        • MR Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Jensen KK et al: Fetal hepatomegaly: causes and associations. Radiographics. 40(2):589-604, 2020
                                                                              2. Larson-Nath C et al: Neonatal acute liver failure. Clin Perinatol. 47(1):25-39, 2020
                                                                              3. Sciard C et al: Prenatal imaging features suggestive of liver gestational allo immune disease. J Gynecol Obstet Hum Reprod. 48(1):61-4, 2019
                                                                              4. Taylor SA et al: The effects of gestational alloimmune liver disease on fetal and infant morbidity and mortality. J Pediatr. 196:123-8.e1, 2018
                                                                              5. Heissat S et al: Neonatal hemochromatosis: diagnostic work-up based on a series of 56 cases of fetal death and neonatal liver failure. J Pediatr. 166(1):66-73, 2015