Alpha-fetoprotein in infantile obstructive jaundice in comparison with the normal ranges

In an attempt to study the diagnostic value of alpha-fetoprotein (AFP), serum AFP concentrations were measured by radioimmunoassay in 34 neonates and infants with obstructive hepatobiliary diseases and the results were compared with the normal ranges of AFP at this age. Eighteen of 24 infants with biliary atresia and four of six infants with neonatal hepatitis had raised AFP values. In only one of four infants with choledochal cyst, did the AFP value exceed the normal range. In 10 older children with this lesion, AFP was normal. Serum AFP concentrations in biliary atresia did not correlate with the serum bilirubin, s-GOT, s-GPT, anatomic type of the lesion or postoperative bile flow. From these observations, it would appear that the elevation of AFP in infantile cholestasis is unrelated to underlying diseases except in case of alpha 1-antitrypsin deficiency. Serum AFP concentrations in neonates with physiological jaundice, were seldom elevated, and showed a good correlation with serum levels of total bilirubin. Possible mechanisms causing this elevation of AFP may be different from those involved in infantile cholestasis.