Progonostic value of serum GGT in infants with intrahepatic cholestasis

Objective Most infants with intrahepatic cholestasis recover completely, only a small proportion of them progress to cirrhosis or death. Some author found that normal or low serum GGT in infants with idiopathic neonatal hepatitis is an indicator of poor prognosis. The aim of this study is to investigate the prognostic value of serum GGT in infants with intrahepatic cholestasis. Methods A retrospective study was conducted in 38 cases of infantile hepatitis, with whom the extrahepatic biliary atresia or other biliary abnormality had been excluded. Children with death, liver transplantation or waiting for liver transplantation, persistent or recurrent jaundice over 1 year of age were regarded as poor prognosis. According to the serum GGT levels at presentation, the 38 patients can be divided into two groups: ≤50 U/L and50 U/L groups. The prognoses were compared between this two groups. Results Patients with GGT≤50 U/L at presentation have poorer prognosis than those with GGT50 U(P=0.001). Poor prognosis was observed in 8 patients. The serum GGT level was normal in 5 of them during the whole follow up period. 2 of this 5 patients died within 1 year. Jaundice persistent or recurrent with persistent pruritus was found in the other 3. 3 of 8 patients who had elevated GGT at presentation, but dropped to normal with the clinical conditions deteriorated. In 72.4% of the cases with good prognosis, AST declined with jaundice when recovered. Levels of GGT reached its peak with the process of remission then dropped to normal in 79.3% patients with good prognosis.Conclusion GGT might be a prognostic parameter in Chinese intrahepatic cholestasis infants. Low level of GGT in infants with persistent jaundice might indicated failure of liver function. Progressive familial intrahepatic cholestasis may also existed in Chinese infants.