Mohamed Abdel-Salam El-Guindi1, Mostafa Mohamed Sira2, Ahmad Mohamed Sira1, Tahany Abdel-Hameed Salem1, Osama Lotfy El-Abd3, Hatem Abdel-Sattar Konsowa1, Dina Shehata El-Azab4, Alif Abdel-Hakim Allam1. 1. Department of Pediatric Hepatology, National Liver Institute, Menofiya University, 32511 Shebin El-koom, Menofiya, Egypt. 2. Department of Pediatric Hepatology, National Liver Institute, Menofiya University, 32511 Shebin El-koom, Menofiya, Egypt. Electronic address: msira@liver-eg.org. 3. Department of Radiology, National Liver Institute, Menofiya University, 32511 Shebin El-koom, Menofiya, Egypt. 4. Department of Pathology, National Liver Institute, Menofiya University, 32511 Shebin El-koom, Menofiya, Egypt.
Abstract
BACKGROUND & AIMS: The dilemma of early diagnosis of biliary Atresia (BA), particularly distinguishing it from other causes of neonatal cholestasis is challenging. The aim was to design and validate a scoring system for early discrimination of BA from other causes of neonatal cholestasis. METHODS: A twelve-point scoring system was proposed according to clinical, laboratory, ultrasonographic, and histopathological parameters. A total of 135 patients with neonatal cholestasis in two sets were recruited to design (n=60) and validate (n=75) a scoring system. Parameters with significant statistical difference between BA (n=30) and non-BA (n=30) patients in the design set were analyzed by logistic regression to predict the presence or absence of BA then a scoring system was designed and validated. RESULTS: The total score ranged from 0 to 37.18 and a cut-off value of >23.927 could discriminate BA from other causes of neonatal cholestasis with sensitivity and specificity of 100% each. By applying this score in the validation set, the accuracy was 98.83% in predicting BA. The diagnosis of BA was proposed correctly in 100% and the diagnosis of non-BA was proposed correctly in 97.67% of patients. By applying this model, unnecessary intraoperative cholangiography would be avoided in non-BA patients. CONCLUSIONS: This scoring system accurately separates infants with BA and those with non-BA, rendering intraoperative cholangiography for confirming or excluding BA unnecessary in a substantial proportion of patients.
BACKGROUND & AIMS: The dilemma of early diagnosis of biliary Atresia (BA), particularly distinguishing it from other causes of neonatal cholestasis is challenging. The aim was to design and validate a scoring system for early discrimination of BA from other causes of neonatal cholestasis. METHODS: A twelve-point scoring system was proposed according to clinical, laboratory, ultrasonographic, and histopathological parameters. A total of 135 patients with neonatal cholestasis in two sets were recruited to design (n=60) and validate (n=75) a scoring system. Parameters with significant statistical difference between BA (n=30) and non-BA (n=30) patients in the design set were analyzed by logistic regression to predict the presence or absence of BA then a scoring system was designed and validated. RESULTS: The total score ranged from 0 to 37.18 and a cut-off value of >23.927 could discriminate BA from other causes of neonatal cholestasis with sensitivity and specificity of 100% each. By applying this score in the validation set, the accuracy was 98.83% in predicting BA. The diagnosis of BA was proposed correctly in 100% and the diagnosis of non-BA was proposed correctly in 97.67% of patients. By applying this model, unnecessary intraoperative cholangiography would be avoided in non-BA patients. CONCLUSIONS: This scoring system accurately separates infants with BA and those with non-BA, rendering intraoperative cholangiography for confirming or excluding BA unnecessary in a substantial proportion of patients.
Authors: Sanjiv Harpavat; Philip J Lupo; Loriel Liwanag; John Hollier; Mary L Brandt; Milton J Finegold; Benjamin L Shneider Journal: J Pediatr Gastroenterol Nutr Date: 2018-06 Impact factor: 2.839
Authors: Marcello Napolitano; Stéphanie Franchi-Abella; Beatrice Maria Damasio; Thomas Angell Augdal; Fred Efraim Avni; Costanza Bruno; Kassa Darge; Damjana Ključevšek; Annemieke Simone Littooij; Luisa Lobo; Hans-Joachim Mentzel; Michael Riccabona; Samuel Stafrace; Seema Toso; Magdalena Maria Woźniak; Giovanni Di Leo; Francesco Sardanelli; Lil-Sofie Ording Müller; Philippe Petit Journal: Pediatr Radiol Date: 2021-05-11
Authors: Marcello Napolitano; Stéphanie Franchi-Abella; Maria Beatrice Damasio; Thomas A Augdal; Fred Efraim Avni; Costanza Bruno; Kassa Darge; Damjana Ključevšek; Annemieke S Littooij; Luisa Lobo; Hans-Joachim Mentzel; Michael Riccabona; Samuel Stafrace; Seema Toso; Magdalena Maria Woźniak; Gianni Di Leo; Francesco Sardanelli; Lil-Sofie Ording Müller; Philippe Petit Journal: Pediatr Radiol Date: 2020-11-17