Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Atresia and hypoplasia of the bile ducts are the most common congenital biliary anomalies of clinical importance. Surgical correction can help about 10% of these infants. However, surgery should be performed within the first month of life to avoid irreversible liver parenchymal changes. It is difficult to separate the surgical condition, biliary atresia, from conditions in which the trauma of laparotomy should be avoided, such as neonatal hepatitis and other clinically indistinguishable causes of obstructive jaundice. Radionuclide imaging with the 99mTc-labeled N-substituted iminodiacetic acids (HIDA, PIDIDA, DISIDA, etc) have been helpful in the differential diagnosis of biliary atresia.
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PMID:Differentiation of jaundice in infancy: an application of radionuclide biliary studies. 407 38

A simple, nonsurgical means of differentiating biliary atresia (BA) from neonatal hepatitis has remained elusive. To determine its diagnostic usefulness, serum gamma-glutamyl transpeptidase (GGTP) levels were measured prospectively in 17 infants (aged 5 to 16 weeks) admitted consecutively to rule out BA. Seven patients were found to have BA, seven had neonatal hepatitis (NH), and three had alpha 1-antitrypsin (A1A) deficiency. The mean maximal GGTP level in those patients with NH (183 +/- 54 IU/L) was significantly lower than that found in patients with BA (760 +/- 492 IU/L) or A1A deficiency (1,725 +/- 921 IU/L). In the 14 patients without A1A deficiency, a serum GGTP level greater than 300 IU/L correctly identified six of seven patients with BA, while a GGTP level less than 300 IU/L correctly identified seven of seven patients with NH, although including one false-negative finding, in a patient with choledochal cyst and BA.
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PMID:Use of gamma-glutamyl transpeptidase in the diagnosis of biliary atresia. 611 Mar 34

Early surgical intervention in cases of extrahepatic biliary atresia improves prognosis. The ratio of serum gamma-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 atresis 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 alpha 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.
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PMID:Elevated GGTP/SGOT ratio. An early indicator of infantile obstructive cholangiopathy. 611 29

Time-activity curves of technetium-labeled diethyl-IDA were used to evaluate 31 patients in an effort to differentiate infants with cholestatic jaundice. Results can be obtained rapidly with minimal radiation exposure and no known secondary effects. The combination of diethyl-IDA time-activity curves and gamma glutamyl transferase activity was found to discriminate biliary atresia from neonatal hepatitis. The group with neonatal hepatitis was characterized by abnormal, yet lower, gamma glutamyl transferase activities and diethyl-IDA time-activity curves which peaked within 1 minute of injection, yet decayed in a manner similar to cardiac activity. The group with biliary atresia was characterized by elevated gamma glutamyl transferase activities, hepatic peaks at 8 minutes and markedly delayed decay. In that early operative intervention is associated with increased survival in biliary atresia, prompt differentiation should improve prognosis.
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PMID:Differentiation of cholestatic jaundice in infants. Utility of diethyl-IDA. 611 33

In an attempt to study the diagnostic value of alpha-fetoprotein (AFP), serum AFP concentrations were measured by radioimmunoassay in 34 neonates and infants with obstructive hepatobiliary diseases and the results were compared with the normal ranges of AFP at this age. Eighteen of 24 infants with biliary atresia and four of six infants with neonatal hepatitis had raised AFP values. In only one of four infants with choledochal cyst, did the AFP value exceed the normal range. In 10 older children with this lesion, AFP was normal. Serum AFP concentrations in biliary atresia did not correlate with the serum bilirubin, s-GOT, s-GPT, anatomic type of the lesion or postoperative bile flow. From these observations, it would appear that the elevation of AFP in infantile cholestasis is unrelated to underlying diseases except in case of alpha 1-antitrypsin deficiency. Serum AFP concentrations in neonates with physiological jaundice, were seldom elevated, and showed a good correlation with serum levels of total bilirubin. Possible mechanisms causing this elevation of AFP may be different from those involved in infantile cholestasis.
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PMID:Alpha-fetoprotein in infantile obstructive jaundice in comparison with the normal ranges. 616 59

Alphafetoprotein (AFP) production was investigated clinically and histologically in cases of congenital biliary atresia and neonatal hepatitis. While serum AFP levels were all higher than 16,000 ng/ml in seven patients with neonatal hepatitis, they were less than 10,000 ng/ml in 50 per cent of 12 patients with biliary atresia. Therefore, serum AFP levels below 10,000 ng/ml were suggestive of a diagnosis of biliary atresia. A number of AFP granules were identified in the liver cells and multinucleated giant cells in patients with neonatal hepatitis and biliary atresia, using an immunoperoxidase method. The serum AFP levels paralleled the number of cells with AFP granules. However, no characteristic differences in distribution of these granules occurred in the hepatic cells and giant cells. The AFP producing mechanism was qualitatively the same in neonatal hepatitis and biliary atresia. These phenomena suggest that congenital biliary atresia and neonatal hepatitis may have the same pathogenesis.
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PMID:Alphafetoprotein in congenital biliary atresia and neonatal hepatitis. 617 7

Lectin affinities of AFP were analyzed using Con A sepharose chromatography and crossed immuno-affino-electrophoresis. With Con A, AFP was divided into three subfractions, nonbound, loosely-bound and tightly-bound by chromatography, or two subfractions, nonbound and bound by electrophoresis. Con A nonbound subfraction was small in percentage in hepatocellular carcinoma (HCC), neonatal hepatitis, congenital biliary atresia (CBA), liver cirrhosis (LC) and cord sera. In contrast with these, the increase of Con A non-bound AFP was observed in yolk sac tumor (YST) and metastatic liver cancer (Meta). With LCA, AFP was divided into three subfractions: nonbound, loosely bound and tightly bound. Loosely bound fraction was very small in every specimen. AFPs from cord sera and LC showed uniform LCA affinity pattern, but AFPs from HCC were not uniform. Our data suggest that the analyses of lectin affinity of AFP serve as a diagnostic tool in differentiating (1) HCC from YST, (2) HCC from Meta, (3) CBA or neonatal hepatitis from YST and (4) LC from some cases of HCC.
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PMID:[Analysis of lectin-affinity of alpha fetoprotein-diagnostic approach]. 619 65

We determined by affinity chromatography on concanavalin A-Sepharose the carbohydrate variant patterns of alphafetoprotein in the sera of 15 infants and children with endodermal sinus tumors (five cases), a neonatal mature teratoma (one case), hepatoblastomas (two cases), pancreatic carcinoma (one case), biliary atresia (four cases), neonatal hepatitis (one case) and neonatal hyperbilirubinemia (one case), in the sera from four normal neonates, and in the sera from two kinds of nude mice bearing human endodermal sinus tumors. Sera from patients with endodermal sinus tumors and pancreatic carcinoma were found to contain a relatively high proportion (48.4 +/- 4.5 and 52.6%) of alphafetoprotein which did not bind to concanavalin A. Sera from nude mice with human endodermal sinus tumors contained AFP, 96.2% of which did not bind to concanavalin A. Sera from patients with other lesions (nine cases) and from normal neonates, whose AFPs are all presumed to be of hepatic origin, contained much less (5.9 +/- 3.6%) of the concanavalin A non-binding AFP variant. These results indicate that human AFP has three distinct patterns of reactivity with concanavalin A and that studies in xenograft models may give important information relating to the glycosylation and secretion process of AFP.
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PMID:Lectin-binding heterogeneity of alphafetoprotein (AFP). An observation in nude mouse xenografts of endodermal sinus tumors and in pediatric surgical patients. 619 51

Twenty-three infants with neonatal cholestasis were examined laparoscopically. The differential diagnosis between biliary atresia and neonatal hepatitis was not established by-clinical and laboratory investigations. In 10 out of 23 cases the transcutaneous-transhepatic-cholangiography, performed with laparoscopy demonstrated the permeability of the biliary tree in children that are not suffering from the atresia. The hepatic biopsy by laparoscopic view allowed to complete the investigation in these cases, avoiding unnecessary laparotomy. In infants suffering from biliary atresia the surgery indication was early and exact.
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PMID:[Cholangiography via laparoscopy in the differential diagnosis of neonatal hepatitis and bile duct atresia]. 622 59

Serologic evidence of hepatitis A virus (HAV) or hepatitis B virus (HBV) infection was sought in 14 patients with biliary atresia and in four patients with neonatal hepatitis; maternal serum was also analyzed. Specific sensitive radioimmunoassays were used to detect HBV surface antigen (HBsAg) and antibody (anti-HBs); complement fixation was used to detect antibody to HBV core antigen (anti-HBc). Antibody to HAV (anti-HAV) was assayed by radioimmunoassay, as well as by immune adherence hemagglutination. There was no evidence of active or past HBV infection in any infant or mother studied. All three infants with detectable anti-HAV were born to mothers similarly anti-HAV positive; serial testing of sera from two of these infants documented disappearance of detectable anti-HAV by 9 months of age. It is unlikely, therefore, that either HAV or HBV had an etiologic role in neonatal cholestasis in these patients. The role of other (non-A, non-B) hepatitis viruses or nonviral etiologies must be investigated.
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PMID:Negative serology for hepatitis A and B viruses in 18 cases of neonatal cholestasis. 625 Jan 25


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