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Titolo:
Hepatic technetium-99m-mebrofenin iminodiacetate scans and serum gamma-glutamyl transpeptidase levels interpreted in series to differentiate between extrahepatic biliary atresia and neonatal hepatitis
Autore:
Arora, NK; Kohli, R; Gupta, DK; Bal, CS; Gupta, AK; Gupta, SD;
Indirizzi:
All India Inst Med Sci, Dept Paediat, Div Paediat Gastroenterol Hepatol & Nutr, New Delhi 110029, India All India Inst Med Sci New Delhi India 110029 r, New Delhi 110029, India All India Inst Med Sci, Dept Pediat Surg, New Delhi 110029, India All India Inst Med Sci New Delhi India 110029 g, New Delhi 110029, India All India Inst Med Sci, Dept Nucl Med, New Delhi 110029, India All India Inst Med Sci New Delhi India 110029 d, New Delhi 110029, India All India Inst Med Sci, Dept Radio Diag, New Delhi 110029, India All IndiaInst Med Sci New Delhi India 110029 g, New Delhi 110029, India All India Inst Med Sci, Dept Pathol, New Delhi 110029, India All India Inst Med Sci New Delhi India 110029 l, New Delhi 110029, India
Titolo Testata:
ACTA PAEDIATRICA
fascicolo: 9, volume: 90, anno: 2001,
pagine: 975 - 981
SICI:
0803-5253(200109)90:9<975:HTISAS>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
CHOLESTASIS BYLER-DISEASE; TRIANGULAR CORD SIGN; INTRAHEPATIC CHOLESTASIS; TRANSFERASE TRANSPEPTIDASE; HEPATOBILIARY SCINTIGRAPHY; DIAGNOSIS; CHILDREN; BIOPSY;
Keywords:
extrahepatic biliary atresia; neonatal cholestasis; neonatal hepatitis; serum GGTP level; Tc-99m-mebrofenin IDA scan;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Arora, NK All India Inst Med Sci, Dept Paediat, Div Paediat Gastroenterol Hepatol & Nutr, New Delhi 110029, India All India Inst Med Sci New Delhi India 110029 hi 110029, India
Citazione:
N.K. Arora et al., "Hepatic technetium-99m-mebrofenin iminodiacetate scans and serum gamma-glutamyl transpeptidase levels interpreted in series to differentiate between extrahepatic biliary atresia and neonatal hepatitis", ACT PAEDIAT, 90(9), 2001, pp. 975-981

Abstract

Hepatic technetium-99m-mebrofenin iminodiacetate (Tc-99m-mebrofenin IDA) scans and serum gamma -glutamyl transpeptidase (GGTP) have high sensitivity for extrahepatic biliary atresia (EHBA). This study was based on the hypothesis that the interpretation of results of 99mTc-mebrofenin IDA scans and serum GGTP levels in series would result in a reduction of the false positivity observed with these tests individually. The aetiology of neonatal cholestasis in 132 study patients was: 25% (33/132) EHBA, 45.5% (60/132) neonatal hepatitis (NH) with an identifiable cause and 19.7% (26/132) idiopathic NH. Of the various clinical, biochemical and imaging parameters that were significantly different between patient groups, sensitivity for EHBA was: serum GGTP greater than or equal to 150 IU l(-1) (100%), Tc-99m-mebrofenin IDAscans (100%), pale stools (82.8%) and total serum bilirubin greater than or equal to 12 mg dl(-1) (66%). However, specificity ranged from 48.5 to 79%. Of the 63 patients who had non-excreting IDA scans, operative cholangiograms could be avoided on the basis of a specific aetiological diagnosis of NH, made concurrently, in only 9 infants. The rest (54) underwent operative cholangiograms; 21 (39%) of these had patent biliary trees and therefore underwent the procedure unnecessarily. If serum GGTP (< 150 IU l(-1)) had been used as a screen after IDA scanning in these 54 patients, operative cholangiograms could have been avoided in another 12 patients and thereafter only 9/42 (21%) of the operative cholangiograms would have been considered unnecessary. Conclusion: A diagnostic algorithm is proposed wherein serum GGTP level (at a cut-off level that maintains 100% sensitivity for EHBA) is used in series with non-excreting Tc-99m-mebrofenin IDA scans (for patients with no specific aetiological label). This strategy reduces the false positivity of individual tests.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/10/20 alle ore 01:20:30