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Low incidence of alpha 1‐antitrypsin deficiency among Filipinos with neonatal cholestatis
Author(s) -
Tan Josephine J,
Cutiongcodela Paz Eva Maria,
Avila Jose Maria C,
Gregorio Germana V
Publication year - 2006
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/j.1440-1754.2006.00953.x
Subject(s) - medicine , incidence (geometry) , jaundice , alpha 1 antitrypsin deficiency , gastroenterology , neonatal cholestasis , liver biopsy , cholestasis , allele , population , genotype , neonatal hepatitis , biopsy , pathology , pediatrics , biliary atresia , genetics , biology , physics , environmental health , gene , transplantation , optics , liver transplantation
Aim: Alpha 1‐antitrypsin (AAT) deficiency is the most common genetic cause of liver disease in children. The Pi*S carrier rate among Filipinos is <1%. Its significance in Filipino infants with neonatal cholestasis has not been investigated. The aim of the study was to determine the incidence of AAT deficiency among Filipino infants presenting with neonatal cholestasis. Methods: Genotype determination that detects Pi*S and Pi*Z alleles was performed using Elucigene AAT reagents (Cellmark Diagnostics, UK). AAT inclusions were identified by light microscopy using periodic acid‐Schiff (PAS) stain. Results: Ninety‐six infants (mean age: 89 days, 48 males) with a history of jaundice since 2 weeks old and a direct bilirubin level >20% of the total were recruited. Only one patient (1 month old, male) was positive for Pi*S allele and 95 were negative for Pi*S and Pi*Z alleles, with an annual incidence of 0.7%. Of the 96, 49 infants underwent diagnostic percutaneous liver biopsy. All liver biopsy specimen were subjected to PAS stain and two infants, 2 and 4 months old, both with idiopathic neonatal hepatitis, had suspicious findings of AAT globules that was confirmed on immunostain. Both infants were negative for Pi*S alleles. The only patient positive for Pi*S allele was negative for PAS globule on liver biopsy. Conclusion: Our results showed a low incidence of AAT deficiency caused by the Pi*S and Pi*Z alleles among Filipino infants presenting with neonatal cholestasis, similar to the low carrier rate in the population.