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Continuous 13C Methacetin Breath Test Differentiates Biliary Atresia from other Causes of Neonatal Cholestasis: Results of a Pilot Study.
MedLine Citation:
PMID:  22695040     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Distinguishing biliary atresia (BA) from other causes of neonatal cholestasis (NC) is challenging. Continuous BreathIDC-Methacetin breath test (MBT, Exalenz Ltd.) is a novel method that determine liver function. Methacetin is metabolized uniquely by the liver and CO2 is measured passively, through a nasal canula in the exhaled breath. AIM:: To assess the ability of MBT to differentiate BA from other causes of NC. METHODS:: MBT was performed in infants with NC prior to any invasive procedure. Percent dose recovered (PDR) peak and time to peak (TTPP) of C recovered were correlated with blood tests results and degree of fibrosis on liver biopsy. RESULTS:: Fifteen infants were enrolled in the study. Eight were eventually diagnosed as BA. MBT showed that infants with NC from various causes reached the PDR peak after 44.5 ± 6.7 minutes, while infants with BA reached the PDR peak value after 54.7 ± 4.3 minutes (p < 0.005). This suggested low CYP1A2 activity in the BA group. The area under the curve (AUC) was 0.95 (95% CI, 0.83-1), sensitivity of 88% and specificity of 100%. CONCLUSIONS:: This pilot study shows that MBT can differentiate between BA and other causes of NC by time to peak of Methacetin metabolism. The results suggest that MBT may be used as part of the diagnostic algorithm in infants with liver disease. Larger scale studies should be conducted to confirm these initial observations.
Authors:
Eyal Shteyer; Gadi Lalazar; Nilla Hemed; Orit Pappo; Esther Granot; Baruch Yerushalmi; Eitan Gross
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-12
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  -     ISSN:  1536-4801     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
*Pediatric Gastroenterology Unit, Department of Pediatrics †Liver Unit, Department of Medicine ‡Departement of Pathology §Department of Pediatric Surgery, Hadassah- Hebrew University Medical Center, Jerusalem, Israel ||Kaplan Medical Center, Rehovot, Israel ¶Soroka Medical Center, Ben Gurion University of the Negev Beer Sheva, Israel.
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