Alphafetoprotein in congenital biliary atresia and neonatal hepatitis

Alphafetoprotein (AFP) production was investigated clinically and histologically in cases of congenital biliary atresia and neonatal hepatitis. While serum AFP levels were all higher than 16,000 ng/ml in seven patients with neonatal hepatitis, they were less than 10,000 ng/ml in 50 per cent of 12 patients with biliary atresia. Therefore, serum AFP levels below 10,000 ng/ml were suggestive of a diagnosis of biliary atresia. A number of AFP granules were identified in the liver cells and multinucleated giant cells in patients with neonatal hepatitis and biliary atresia, using an immunoperoxidase method. The serum AFP levels paralleled the number of cells with AFP granules. However, no characteristic differences in distribution of these granules occurred in the hepatic cells and giant cells. The AFP producing mechanism was qualitatively the same in neonatal hepatitis and biliary atresia. These phenomena suggest that congenital biliary atresia and neonatal hepatitis may have the same pathogenesis.