Abstract
Background : Biliary atresia (BA) is a progressive disease of infancy. Early diagnosis is particularly essential because prognosis is closely related with timing of Kasai portoenterostomy. There is no non-invasive method that clearly identifies the diagnosis. Tumor necrosis factor-α (TNF-α) is a cytokine which is mainly produced by activated macrophages and monocytes. Aim : We aimed to study the performance of serum TNF-α in BA and other neonatal cholestatic disorders. Materials and Methods : The study included 80 infants with neonatal cholestasis divided in two groups; BA group (n=40), non-BA group (n=40) with cholestatic disorders other than BA. Demographic, clinical, laboratory, and histopathological parameters were collected. Serum TNF-α level was measured by enzyme-linked immunosorbent assay. Results : The mean value of TNF-α level was significantly higher in BA group (260.61+155.74 pg/ml) compared to non-BA (126.26+ 64.23 pg/ml) and a cutoff level of 124.4 pg/ml can diagnose BA with 95 % sensitivity and specificity 75 %. TNF-α is correlated with alkaline phosphatase, gamma glutamyle transferase and grade of liver fibrosis (P value 0.019, 0.004 and < 0.0001 respectively). In Conclusion : Serum TNF-α can be used as a non-invasive and sensitive marker for confirming the diagnosis of BA in in suspicious cases.
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