Anti-smooth muscle antibodies and liver enzymes in differentiation of extrahepatic biliary atresia and idiopathic neonatal hepatitis: Concern in laboratory medicine view.

Sir,

The recent report on ‘anti-smooth muscle antibodies and liver enzymes in differentiation of extrahepatic biliary atresia and idiopathic neonatal hepatitis (INH)’ is very interesting.[1] Rafeey et al. concluded that ‘anti-smooth muscle antibodies (ASMA) may be a useful biomarker for differentiation of extrahepatic biliary atresia from idiopathic neonatal hepatitis (INH)'[1] and ‘further studies with larger samples are recommended for confirming the results of this study'.[1] As noted by Rafeey et al.,[1] the main concern of this report is on the few cases. Nevertheless, there are also other concerns in laboratory medicine. First, the quality control of the investigation is very important.[2] Furthermore, the confirmation of INH has to be further rule out the possible problem from many viral hepatitis. For example, hepatitis, which can be transmitted from mother to offspring, can be the cause of aberrant ASMA results.[3]

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