Biliary Atresia: GGT vs Histopathology as Diagnostic Tool

Background: Biliary Atresia (BA) also known as "progressive obliterative cholangiopathy" is one of the most common conditions requiring pediatric liver transplant and the most common surgically treatable cause of neonatal cholestasis. Associated malformations are present in 25% of cases and it is most common in East Asia, with incidence reported as high as one in 5,000. BA presents with cholestatic Jaundice, initially indistinguishable from physiological jaundice. Symptoms include progressive cholestasis, causing yellowing of the skin, pruritis, pale stools, dark urine.

Methods: This study is a Cross sectional study conducted at the Department of Pediatric Medicine, The Children’s Hospital & Institute of Child’s Health, Lahore in the duration of 6 months (2018-2019), after approval from the Institution’s Review Board. All patients of age ≤ 14 months, presenting in pediatric emergency with cholestatic jaundice and fulfilling inclusion criteria were included in this study.

Results: In our study a total of 150 cases were enrolled. The mean age of patients in months was 7.13 ± 3.81. The male to female ratio of the patients was 1.3:1, 86(57.33%) males and 64(42.67%) females. The results showed that the mean initial observation of jaundice was 8.54 ± 3.89 days with minimum and maximum duration of 2 & 15 days, respectively. In our study the mean GGT level of the patients was 303.13 ± 58.53. In our study, on the basis of GGT level BA was diagnosed positive in 83 cases and negative in 67 cases, which was exceptionally consistent with the gold standard i.e. histopathology which diagnosed 82 cases as positive for BA and labelled 68 cases negative.

Conclusion: Serum GGT elevated levels are suggestive of biliary atresia.