title: Hyaluronic acid: additional biochemical marker in the diagnosis of biliary atresia.
abstract: BACKGROUND
  The purpose of the present paper was to evaluate the value of biochemical markers, including conventional liver function tests, gamma-glutamyl transferase (GGT), and hyaluronic acid (HA), in the diagnosis of neonatal cholestasis.
  
  
  METHODS
  Infants with neonatal jaundice were consecutively enrolled during 1 year period. The patients were diagnosed as having biliary atresia (BA) if there was either bile ductular proliferation in the portal tracts, atretic common bile duct/gallbladder, or evidence of bile duct obstruction demonstrated by liver pathology or intraoperative cholangiography, respectively. Serum HA was measured using an enzyme-linked immunosorbent assay-based test.
  
  
  RESULTS
  A total of 25 patients diagnosed as having BA (n = 10), neonatal hepatitis (NH; n = 9), choledochal cyst (n = 3) and parenteral nutrition-induced cholestasis (n = 3), were studied. The age at diagnosis was not significantly different between groups. Only GGT and HA were significantly elevated in the patients with BA when compared to NH (P = 0.02, P = 0.03, respectively). In BA, the median value of serum HA was 514 ng/mL (range 19-4476 ng/mL), compared to 50 ng/mL (range 19-315 ng/mL) in NH. Additionally, the serum HA level was much higher in children with choledochal cyst.
  
  
  CONCLUSIONS
  HA could be considered as a complementary biochemical marker for evaluating infants with prolonged jaundice.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. nukarapo@chiangmai.ac.th
authors.forename: Nuthapong
authors.initials: N
authors.lastname: Ukarapol
authors.forename: Lumduan
authors.initials: L
authors.lastname: Wongsawasdi
authors.forename: Siriwan
authors.initials: S
authors.lastname: Ong-Chai
authors.forename: Pornthawee
authors.initials: P
authors.lastname: Riddhiputra
authors.forename: Prachya
authors.initials: P
authors.lastname: Kongtawelert
mesh_terms: D001656:Biliary Atresia / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D007223:Infant; D008297:Male
chemical_list: D015415:Biomarkers; D006820:Hyaluronic Acid