Elevated GGTP/SGOT ratio. An early indicator of infantile obstructive cholangiopathy

M. S. Platt, J. L. Potter, C. R. Boeckman and C. Jaberg

Early surgical intervention in cases of extrahepatic biliary atresia improves prognosis. The ratio of serum gamma-glutamyl transpeptidase to SGOT is elevated in infants with infantile obstructive cholangiopathy. This appears to be a sensitive method for distinguishing infants with extrahepatic biliary atresis from those with neonatal hepatitis. This distinction was evident as early as 5 to 14 days of age and was clearly manifest in ten of 12 infants with biliary atresia. The ratio was also elevated in patients with alpha 1-antitrypsin deficiency who had bile duct proliferation. We do not claim that the ratio can clearly distinguish extrahepatic biliary atresia from neonatal hepatitis, but we do suggest that an elevation raises a strong presumption of biliary obstruction and invites early consideration of laparotomy and examination of the biliary tree.