血清ビリルビン抱合体分析による新生児黄疸とくに先天性胆道閉鎖症の鑑別

概要

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The purpose of this study is to clarify the possibility to differentiate congenital biliary atresia from other neonatal jaundice by means of an analysis on bilirubin isomers and its conjugates in serum. It was reported recently by Yamaguchi, et al., that bilirubin conjugate "C", which is isolated as the major bilirubin conjugates in normal human bile, is detected in serum from patients with obstructive jaundice. In the present study, the conjugate "C" in the serum was detected in all 5 cases of CBA and in one out of 3 cases of neonatal hepatitis. In the cases of neonatal physiological jaundice and premature birth no conjugate was detected in their serum. Thus, it is easy to differentiate the latter two neonatal jaundice from CBA or neonatal hepatitis. Differential diagnosis of CBA and neonatal hepatitis is not always easy by the present analysis, however, together with the results on experimental bile duct obstruction in rats, it was recommended that the analysis of serum bilirubin conjugates should be performed as soon as possible after birth in neonates with prolonged jaundice in order to differentiate these two pathological conditons.
日本小児外科学会の論文