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Serum hyaluronic acid as an early prognostic marker in biliary atresia
A Dhawan1, P Trivedi, P Cheeseman
1Department of Child Health, King's College Hospital, London, England.
Insights
High serum hyaluronic acid (HA) levels at diagnosis can predict poor prognosis in infants with biliary atresia (BA). This early marker helps identify patients likely to need liver transplants within five years.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Biochemical Markers
Background:
- Biliary atresia (BA) is a severe neonatal liver disease.
- Early prognostic markers for BA are crucial for timely intervention.
- Hyaluronic acid (HA) is a component of the extracellular matrix implicated in liver fibrosis.
Purpose of the Study:
- To evaluate serum hyaluronic acid (HA) as an early prognostic biomarker in biliary atresia (BA).
- To determine if HA levels at diagnosis correlate with long-term outcomes in infants with BA.
Main Methods:
- Serum HA levels were measured using a radiometric assay at diagnosis in 84 infants diagnosed with BA.
- Patient outcomes, including mortality and need for liver transplantation, were tracked up to 5 years of age.
Main Results:
- Infants with BA who died or required liver transplantation by age 5 had significantly higher serum HA concentrations compared to survivors.
- Mean serum HA levels were 490 +/- 216 microg/L in the poor prognosis group versus 262 +/- 163 microg/L in the survivor group (P <.001).
Conclusions:
- Elevated serum HA levels at diagnosis serve as a potential early indicator of poor prognosis in biliary atresia.
- High HA concentrations may identify infants with BA who are at higher risk of requiring liver transplantation by age 5.
Purpose:
The aim of this study was to assess whether serum concentrations of hyaluronic acid (HA), measured at diagnosis is an early biochemical marker of prognosis in biliary atresia.
Methods:
Serum HA was measured at diagnosis using a radiometric assay in 84 infants with biliary atresia (BA), and related to outcome by 5 years of age.
Results:
Serum HA was higher in the 29 patients who died or required liver transplant by 5 years of age compared with the 56 who survived to 5 years without transplant (490 +/- 216 microg/L v 262 +/- 163 microg/L; P <.001, 95% confidence intervals of the difference 145 to 311 microg/L).
Conclusion:
High serum concentrations of HA at diagnosis may help to identify at an early stage those patients with BA who have a poor prognosis and will require liver transplant by 5 years of age.