| The Usefulness of Measuring Serum α-fetoprotein and Thyroxine-binding Globulin to Differentiate between Neonatal Hepatitis and Congenital Extrahepatic Biliary Atresia |
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Soo Kyoung Lee1, Ki Sup Chung2 |
1Department of Pediatrics, Sowha Children`s Hospital, Seoul, Korea
2Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea |
| 신생아간염과 선천성 담도폐쇄증의 감별 진단에 있어서 혈청 -fetoprotein 및 Thyroxine-Binding Globulin치의 유용성 |
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이수경1, 정기섭2 |
1소화아동병원 소아과
2연세대학교 의과대학 소아과학교실 |
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| Abstract |
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Together, neonatal hepatitis and biliary atresia make up approximately 70 to 80% of the causes of neonatal cholestasis. Biliary atresia must be differentiated from neonatal hepatitis as soon as possible in order to institute early surgical intervention. We performed this study to examine whether the measurement of the serum α-fetoprotein(AFP) and thyroxine-binding globulin(TBG) was useful for differentiating these two conditions. Serum AFP levels were mesured using enzyme immunoassay in 76 infants with cholestasis and serum TBG levels were mesured using radio immunoassay in 30 infants with cholestasis and 23 infants without cholestasis. Serum AFP and TBG concentrations in patients were compared with the normal ranges in infants and were expressd as standard deviation(SD) scores. 52.7% of the patients with neontal hepatitis showed SD scores of AFP higher than 4.0. By contrast, 14.3% of the patients with biliary atresia showed SD scores of AFP higher than 4.0(p<0.005). The patients with either neonatal hepatitis or biliary atresia had TBG concentrations above the normal ranges, but there was no difference between neonatal hepatitis and biliary atresia. The patients with neonatal hepatitis who recovered from jaundice after 6 months of age or progressed to chronic liver disease or died of the liver disease showed higher serum levels of AFP and TBG than the patients who recovered from jaundice before 6 months of age.
In conclusion, SD score of AFP could be used to differentiate between neonatal heptatis and biliary atresia, and SD scores of ATF and TBG might be used as an indicator of prognosis of neonatal hepatitis. |
| Key Words:
Neonatal hepatitis, Biliary atresia, α-fetoprotein, Thyroxine-binding globulin |
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