Sim Sai Tin1, Viroj Wiwanitkit2. 1. Medical Science Unit, Hainan Medical University, China. 2. Visiting Professor in Tropical Medicine Unit, Hainan Medical University, China.
Sir,We would like to discuss the report on “bile in various hepatobiliary disease states.”[1] Verma et al. concluded that the components of bile show a close correlation with various clinical and prognostic markers. There is a very close correlation between these parameters and the clinical severity, disease progression and final outcome.[1] In fact, bile analysis is an old laboratory test in body fluid examination. Based on the report by Verma et al., the analysis might seem useful in clinical diagnosis. However, there are some concerns to be addressed. First, the bile component can be affected by several physiological and pathological conditions. For example, dehydration in children might concentrate the bile.[2] In addition, some underlying genetic diseases such as hemoglobinopathies might alter the component of the bile.[3] These factors have to be considered in bile analysis; however, it is not well assessed and mentioned in the report by Verma et al.[1]