Diagnostic Value of Procalcitonin and Apo-E in Extrahepatic Biliary Atresia

Mandana  Rafeey; Lida  Saboktakin; Jamshid  Shoa Hassani; Fatemeh  Farahmand; Saied  Aslanabadi; Amir  Ghorbani-Haghjou; Sadegh Poorebrahim

IJ Pediatrics

The Scientific Journal of Growth & Development Research Center

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Diagnostic Value of Procalcitonin and Apo-E in Extrahepatic Biliary Atresia

Author(s):

Mandana Rafeey¹,

Lida Saboktakin^2,*,

Jamshid Shoa Hassani ³,

Fatemeh Farahmand⁴,

Saied Aslanabadi⁵,

Amir Ghorbani-Haghjou⁶,

Sadegh Poorebrahim⁷

IJ Pediatrics:Vol. 24, issue 5; 623-629

Published online:Feb 18, 2014

Article type:Research Article

Received:Jul 20, 2013

Accepted:Jan 11, 2014

How to Cite:Mandana RafeeyLida SaboktakinJamshid Shoa Hassani Fatemeh FarahmandSaied AslanabadiAmir Ghorbani-HaghjouSadegh Poorebrahimet al.Diagnostic Value of Procalcitonin and Apo-E in Extrahepatic Biliary Atresia.Iran J Pediatr.24(5):623-629.

Abstract

Objective: Extrahepatic biliary atresia (EHBA) is one of the main causes of neonatal cholestasis. Its early diagnosis could increase the survival of the infants with early surgery. We evaluated the diagnostic accuracy of procalcitonin and apolipoprotein E (Apo-E) levels in infants with and without EHBA. Methods: This prospective study included 18 infants with EHBA and 15 infants with other causes of cholestasis. Blood samples were taken from each patient and different markers including procalcitonin and Apo-E levels were measured. ROC analysis was used to define sensitivity, specificity, positive and negative predictive value (PPV and NPV) for procalcitonin and Apo-E. Findings: There was a significantly positive correlation between Apo-E and SGOT (r=0.37, P=0.03), SGPT (r=0.38, P=0.02) and GGT (r=0.38, P=0.02), and an inverse correlation between procalcitonin and GGT (r=-0.45, P=0.01). Area under curve (AUC) for procalcitonin was 0.69 (P=0.05) with cut-point of 0.735 ng/ml. The sensitivity, specificity, PPV and NPV was 67%, 61%, 69% and 59%, respectively. AUC for Apo-E was 0.68 (P=0.06) for cut-point of 61.25 ng/ml with sensitivity, specificity, PPV and NPV of 67%, 67%, 71% and 67%, respectively. Conclusion: Both PCT and Apo-E have relatively good accuracy in diagnosing EHBA cases; we could not rely on these markers for diagnosis of EHBA, however, combinations of these biomarkers with other markers and imaging tests could improve their accuracy and may help to achieve a rapid and accurate diagnosis of EHBA.

Keywords

Neonatal Cholestasis

Extrahepatic Biliary Atresia

Procalcitonin

Apolipoprotein E

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