Use of γ-Glutamyl Transpeptidase in the Diagnosis of Biliary Atresia

• A simple, nonsurgical means of differentiating biliary atresia (BA) from neonatal hepatitis has remained elusive. To determine its diagnostic usefulness, serum γ-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 α₁-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.

(Am J Dis Child 1981;135:134-136)