The Prognostic Value of Serum Gamma Glutamyltransferase Activity in Chinese Infants with Previously Diagnosed Idiopathic Neonatal Hepatitis

Background and Aim: The significance of serum gamma glutamyltransferase activity and its dynamics have not been well investigated in Asian patients with idiopathic neonatal hepatitis. This study aimed to explore the significance in Mainland China. Methods: A retrospective analysis was performed in 38 cases with a diagnosis of idiopathic neonatal hepatitis. Their prognosis was compared between low or high gamma glutamyltransferase groups, and the mechanics of biochemical parameters were analysed. Results: Poor prognosis was found in 5 out of 6 patients with low gamma glutamyltransferase, compared to 3 out of 32 patients with high gamma glutamyltransferase (P=0.001). Dynamic analysis found that serum gamma glutamyltransferase levels gradually rose to a peak and then normalised along with a remission of jaundice in patients with good prognosis. However, the serum gamma glutamyltransferase level was consistently low in spite of the fluctuations of bilirubin and aminotransferases level in 5 cases with poor prognosis. The gamma glutamyltransferase level was high at presentation and then decreased along with their clinical deterioration in the other 3 cases with poor prognosis. Conclusions: Gamma glutamyltransferase can be used as a prognostic parameter in Chinese infants with intrahepatic cholestasis. Serum gamma glutamyltransferase being consistently low or decreased along with jaundice persistence or deterioration predicts poor prognosis.