Value of Gamma-Glutamyl Transpeptidase for Diagnosis of Biliary Atresia by Correlation with Age.

Objectives: Study the value of gamma-glutamyl transpeptidase (GGT) for distinguishing biliary atresia (BA) from non-BA for patients suspected of having neonatal obstructive jaundice (NOJ) by correlation with age. Methods: From January 2003 to March 2014, cholangiography and/or surgical exploration were undertaken in 1469 patients with suspicion of having NOJ. A total of 1338 patients were diagnosed with BA intraoperatively. Preoperative medical records were compared between BA and non-BA patients. Results: Preoperative levels of total bilirubin (TB), direct bilirubin (DB) and GGT were significantly higher in the BA group (p 121 days), BA groups had higher GGT levels (in IU/L) (i: 725.3+/-549.9; ii: 927.0+/-679.8; iii: 1114.3+/-823.1; iv: 767.5+/-666.7). The level of GGT in BA patients younger than 30 days was 834.2+/-475.3 IU/L. GGT levels had the highest diagnostic value (0.869) in group ii (61-90 days) and the lowest diagnosis value (0.712) in group iv (>121 days). At a cutoff of >303 IU/L in group ii (61-90 days), GGT had 82.8% sensitivity and 81.6% specificity for the discrimination of BA. Conclusions: GGT levels contribute to the diagnosis of BA before 120 days. Age must be considered if using GGT levels as a diagnostic test for BA. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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