Significance of low or normal serum gamma glutamyl transferase level in infants with idiopathic neonatal hepatitis.

Jian She Wang, Nancy Tan, Anil Dhawan
Author Information
  1. Jian She Wang: Paediatric Liver Centre, King's College Hospital, Denmark Hill, London SE5 9RS, UK. anil.dhawan@kcl.ac.uk

Abstract

INTRODUCTION: We evaluated the significance of low/normal serum gamma glutamyl transferase (GGT) level in infants with idiopathic neonatal hepatitis (INH).
MATERIALS AND METHODS: A retrospective review of the hospital records of 103 infants less than 3 months of age who were diagnosed with INH between August 1991 and November 2000 was performed. Variables including age at which jaundice was noticed, age at presentation, perinatal risk factors, family history of liver disease, parental consanguinity, initial ultrasound scan, liver biopsy, laboratory values at the first visit, the peak levels of total bilirubin, aspartate aminotransferase (AST), GGT and alkaline phosphatase (ALP) in the first 3 months of follow-up and interval for normalisation of serum bilirubin and AST were compared between infants presenting with low/normal GGT (100 U/L).
RESULTS AND DISCUSSION: Infants with low/normal GGT levels presented earlier (median 36.5 days versus 44 days; p=0.016) and had significantly higher bilirubin and AST levels at presentation (bilirubin 167.5 micromol/L versus 133 micromol/L; p<0.005 and AST 187.5 U/L versus 106 U/L; p<0.001) and at peak levels (bilirubin 170 micromol/L versus 146 micromol/L; p=0.024 and AST 210.5 U/L versus 129 U/L; p=0.001). A significant correlation was also found between GGT levels and serum albumin levels (p=0.004). Patients with low/normal GGT levels were more likely to have giant cell hepatitis on histology (p=0.015). There was no difference in time taken to recovery.
CONCLUSION: Low/normal levels of GGT in INH infants may be a predictor of more severe but recoverable disease.

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MeSH Term

Aspartate Aminotransferases
Bilirubin
Cholestasis
Female
Hepatitis
Humans
Infant
Infant, Newborn
Male
Prognosis
Retrospective Studies
Serum Albumin
Statistics, Nonparametric
gamma-Glutamyltransferase

Chemicals

Serum Albumin
gamma-Glutamyltransferase
Aspartate Aminotransferases
Bilirubin

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