Elevated GGTP/SGOT Ratio

Abstract

\s=b\ Early surgical intervention in cases of extrahepatic biliary atresia improves prognosis. The ratio of serum \g=g\-glutamyl transpeptidase to SGOT is elevated in infants with infantile obstructive cholangiopathy. This appears to be a sensitive method for distinguishing infants with extrahepatic biliary atresia from those with neonatal hepatitis. This distinction was evident as early as 5 to 14 days of age and was clearly manifest in ten of 12 infants with biliary atresia. The ratio was also elevated in patients with \g=a\1-antitrypsin deficiency who had bile duct proliferation. We do not claim that the ratio can clearly distinguish extrahepatic biliary atresia from neonatal hepatitis, but we do suggest that an elevation raises a strong presumption of biliary obstruction and invites early consideration of laparotomy and examination of the biliary tree.(Am J Dis Child 1981;135:834-836) Early surgical intervention in pa¬ tients with extrahepatic biliary atresia improves the prognosis. If patients receive modified Kasai proce¬ dures by 2 months of age, 67% obtain at least a three-year survival, whereas if surgery is delayed to 4 months of age, few, if any, survive.1 Thus, an early indicator of bile duct obstruction and/or severe bile duct proliferation has merit. We have observed the serum -glutamyl transpeptidase (GGTP) and SGOT levels in infants with biliary atresia, a,-antitrypsin deficiency, bile plug syndrome, neona¬ tal hepatitis, and hepatic duct steno¬ sis. The sensitivity of the magnitude of the GGTP/SGGT ratio in relation to clinical circumstances comprises this report.

Circulating MicroRNA Is a Biomarker of Biliary Atresia

“…A timely diagnosis of BA is critical for optimal patient outcome following KPE, yet current noninvasive tests are unable to reliably distinguish BA from other forms of neonatal hyperbilirubinemia. Earlier reports had suggested GGTP as a biomarker of BA (14,15), and this is supported by our results; however, subsequent studies have found that serum GGTP levels are frequently elevated in other forms of neonatal cholestasis (16,17). Wang et al (18) used a proteomic approach to identify 11 serum proteins significantly altered in BA compared with non‐BA cholestasis.…”

The Role of γ‐Glutamyl Transpeptidase in the Preoperative Diagnosis of Biliary Atresia

“…The three infants with <Xcantitrypsin deficiency had serum GGTP levels in the biliary atresia range (869-2.700 lUlL) . Two subsequent investigations of similar size groups of patients reported similar results (10,11). Although mean GGTP levels were significantly higher in infants with biliary atresia, in all three reports instances of patients with biliary atresia.…”

“…The reliability was not improved by evaluating serial GGTP measurements, as suggested by Fung and Lau (12), or by the use of the GGTP/AST ratio, as suggested by Platt and co-workers. (10).…”

Value of Gamma‐Glutamyl Transpeptidase for Diagnosis of Biliary Atresia by Correlation With Age

“…GGT levels have been reported to have high accuracy for differentiation of BA from other causes of NC (11,19). In healthy infants, GGT levels have been shown to be highest younger than 1 month of age (47.4 AE 21.2 IU/L), reduced at 1 to 3 months of age (26.8 AE 23.1 IU/L), and lowest after 5 to 7 months of age (20,21). The correlation between GGT level and age of patients with BA is significant (11), but few studies have considered age when evaluating the accuracy of GGT levels in the diagnosis of BA.…”