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Elevated GGTP/SGOT Ratio: An Early Indicator of Infantile Obstructive Cholangiopathy

Elevated GGTP/SGOT Ratio: An Early Indicator of Infantile Obstructive Cholangiopathy Abstract • Early surgical intervention in cases of extrahepatic biliary atresia improves prognosis. The ratio of serum γ-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 α1-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) References 1. Barkin RM, Lilly JR: Biliary atresia and the Kasai operation: Continuing care . J Pediatr 1980;96:1015-1019.Crossref 2. Karmen A, Wroblewski F, LaDue JS: Transaminase activity in human blood . J Clin Invest 1955;34:126-133.Crossref 3. Serum Glutamic Oxaloacetic Transaminase, SGOT (Aspartate Amino Transferase) Determination for ABA Systems and Manual Chemistries . South Pasadena, Calif, Abbott Scientific Products Division, February 1980. 4. Szasz G: A kinetic photometric method for serum gamma glutamyl transpeptidase . Clin Chem 1969;15:124-136. 5. Determination of Gamma Glutamyl Transpeptidase (GGTP) , Sigma Technical Bulletin 545. St Louis, Sigma Chemical Co, March 1977. 6. Bessey OA, Lowry OH, Brock MJ: A method for the rapid determination of alkaline phosphatase with 5 cu mm of serum . J Biol Chem 1946;164:321-329. 7. Alkaline Phosphatase Determination for ABA Systems . South Pasadena, Calif, Abbott Scientific Products Division, January 1979. 8. LAS-R Human a, Antitrypsin Test for Quantification of Human a, Antitrypsin in Serum . Costa Mesa, Calif, Hyland, Division of Travenol Laboratories, October 1979. 9. Ghishan FK, LaBrecque DR, Mitros FA, et al: The evolving nature of infantile obstructive cholangiopathy . J Pediatr 1980;97:27-32.Crossref 10. De Lorimer AA: Neonatal jaundice and biliary atresia . Surg Clin North Am 1977;57:429-441. 11. Bernstein J, Chang CH, Brough AJ, et al: Conjugated hyperbilirubinemia in infancy associated with parenteral alimentation . J Pediatr 1977;90:361-367.Crossref 12. Maksem JA: Polysplenia syndrome and splenic hypoplasia associated with extrahepatic biliary atresia . Arch Pathol Lab Med 1980;104:212-214. 13. Chandra RS: Biliary atresia and other structural anomalies in the congenital polysplenia syndrome . J Pediatr 1974;85:649-655.Crossref 14. Landing BH: Consideration of the pathogenesis of neonatal hepatitis, biliary atresia, and choledochal cysts: The concept of infantile obstructive cholangiopathy . Prog Pediatr Surg 1974;6:113-139. 15. Brough AJ, Bernstein J: Liver biopsy in the diagnosis of infantile obstructive jaundice . Pediatrics 1969;43:519-526. 16. Brough AJ, Bernstein J: Conjugated hyperbilirubinemia in early infancy: A reassessment of liver biopsy . Hum Pathol 1974;5:507-516.Crossref 17. Hays DM, Wooley MM, Snyder WH, et al: Diagnosis of biliary atresia: Relative accuracy of percutaneous liver biopsy, open liver biopsy, and operative cholangiography . J Pediatr 1967;71:598-607.Crossref 18. Platt MS, Potter JL, Jaberg C, et al: Expected values for ultramicrosamples of liver functions . J Pediatr 1975;86:153-154.Crossref 19. Hadchouel M, Gautier M: Histopathologic study of the liver in the early cholestatic phase of alpha-1-antitrypsin deficiency . J Pediatr 1976;39:211-215.Crossref 20. Lum G, Gambino SR: Serum gamma-glutamyl transpeptidase activity as an indication of desease of liver, pancreas, or bone . Clin Chem 1972;18:358-362. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Elevated GGTP/SGOT Ratio: An Early Indicator of Infantile Obstructive Cholangiopathy

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References (21)

Publisher
American Medical Association
Copyright
Copyright © 1981 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1981.02130330044014
Publisher site
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Abstract

Abstract • Early surgical intervention in cases of extrahepatic biliary atresia improves prognosis. The ratio of serum γ-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 α1-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) References 1. Barkin RM, Lilly JR: Biliary atresia and the Kasai operation: Continuing care . J Pediatr 1980;96:1015-1019.Crossref 2. Karmen A, Wroblewski F, LaDue JS: Transaminase activity in human blood . J Clin Invest 1955;34:126-133.Crossref 3. Serum Glutamic Oxaloacetic Transaminase, SGOT (Aspartate Amino Transferase) Determination for ABA Systems and Manual Chemistries . South Pasadena, Calif, Abbott Scientific Products Division, February 1980. 4. Szasz G: A kinetic photometric method for serum gamma glutamyl transpeptidase . Clin Chem 1969;15:124-136. 5. Determination of Gamma Glutamyl Transpeptidase (GGTP) , Sigma Technical Bulletin 545. St Louis, Sigma Chemical Co, March 1977. 6. Bessey OA, Lowry OH, Brock MJ: A method for the rapid determination of alkaline phosphatase with 5 cu mm of serum . J Biol Chem 1946;164:321-329. 7. Alkaline Phosphatase Determination for ABA Systems . South Pasadena, Calif, Abbott Scientific Products Division, January 1979. 8. LAS-R Human a, Antitrypsin Test for Quantification of Human a, Antitrypsin in Serum . Costa Mesa, Calif, Hyland, Division of Travenol Laboratories, October 1979. 9. Ghishan FK, LaBrecque DR, Mitros FA, et al: The evolving nature of infantile obstructive cholangiopathy . J Pediatr 1980;97:27-32.Crossref 10. De Lorimer AA: Neonatal jaundice and biliary atresia . Surg Clin North Am 1977;57:429-441. 11. Bernstein J, Chang CH, Brough AJ, et al: Conjugated hyperbilirubinemia in infancy associated with parenteral alimentation . J Pediatr 1977;90:361-367.Crossref 12. Maksem JA: Polysplenia syndrome and splenic hypoplasia associated with extrahepatic biliary atresia . Arch Pathol Lab Med 1980;104:212-214. 13. Chandra RS: Biliary atresia and other structural anomalies in the congenital polysplenia syndrome . J Pediatr 1974;85:649-655.Crossref 14. Landing BH: Consideration of the pathogenesis of neonatal hepatitis, biliary atresia, and choledochal cysts: The concept of infantile obstructive cholangiopathy . Prog Pediatr Surg 1974;6:113-139. 15. Brough AJ, Bernstein J: Liver biopsy in the diagnosis of infantile obstructive jaundice . Pediatrics 1969;43:519-526. 16. Brough AJ, Bernstein J: Conjugated hyperbilirubinemia in early infancy: A reassessment of liver biopsy . Hum Pathol 1974;5:507-516.Crossref 17. Hays DM, Wooley MM, Snyder WH, et al: Diagnosis of biliary atresia: Relative accuracy of percutaneous liver biopsy, open liver biopsy, and operative cholangiography . J Pediatr 1967;71:598-607.Crossref 18. Platt MS, Potter JL, Jaberg C, et al: Expected values for ultramicrosamples of liver functions . J Pediatr 1975;86:153-154.Crossref 19. Hadchouel M, Gautier M: Histopathologic study of the liver in the early cholestatic phase of alpha-1-antitrypsin deficiency . J Pediatr 1976;39:211-215.Crossref 20. Lum G, Gambino SR: Serum gamma-glutamyl transpeptidase activity as an indication of desease of liver, pancreas, or bone . Clin Chem 1972;18:358-362.

Journal

American Journal of Diseases of Children – American Medical Association

Published: Sep 1, 1981

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