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13 C‐phenylalanine breath test correlates with liver fibrosis in postoperative biliary atresia
Author(s) -
WADA MASAKI,
WADA YUKO,
UCHIYAMA MAKOTO,
KAJIWARA MASAHIRO,
TAKATORI KAZUHIKO
Publication year - 2007
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.2007.02443.x
Subject(s) - medicine , biliary atresia , gastroenterology , excretion , breath test , phenylalanine , bile acid , albumin , dosing , endocrinology , biochemistry , liver transplantation , amino acid , chemistry , transplantation , helicobacter pylori
Background: Values derived from the 13 C‐phenylalanine breath test (PBT) may serve as an index for liver fibrosis and clinically predictive readings for liver diseases in adults. In the present study the PBT was conducted in postoperative biliary atresia (BA) children to evaluate phenylalanine metabolism in the liver, and the results based on biochemical data, especially the index on liver fibrosis, were compared with PBT findings. Methods: Hepatofunctional evaluations were conducted in 10 postoperative BA children with moderate (group B; n = 4) and severe (group A; n = 6) liver dysfunction, and the PBT results were compared with those of 13 normal healthy children (group C). Subjects were orally given single‐bolus 13 C‐phenylalanine at 3.5 mg/kg (maximum dosing: 100 mg) in the morning. Time‐related exhaled gas was periodically collected until 120 min after dosing. The 13 CO 2 levels were monitored with gas chromatography–mass spectrometry before and after administration, and the 13 C excretion rate, 13 C cumulative excretion and time of maximum 13 C excretion rate were monitored accordingly. Results: Total bile acid, hyaluronic acid, type IV collagen 7S, total bilirubin or albumin and the PBT findings were significantly correlated. The PBT findings in group A were significantly lower those of group B, indicating that phenylalanine metabolism was markedly attenuated in the former. Conclusion: The PBT values correlated well with liver fibrosis in postoperative BA children. Because PBT is a non‐invasive approach, results from this method may serve as a useful and reliable index for post‐surgical monitoring of children operated on for liver fibrosis.