Diagnostic Value of Serum Autotaxin Levels in Liver Fibrosis in Children with Chronic Hepatitis.

M.A.El-Baz1, O.G.Behairy1, A.I.Mansour2and R.A.Elsayed3"


Liver biopsy is the most accurate examination method to evaluate liver fibrosis stage but is invasive. Non-invasive biomarkers of disease progression are therefore needed.The study aimed toassess the role of serum autotoxin levels in diagnosis of liver fibrosis in children with chronic hepatitis.This study was a case controlled study that was conducted on a total number of 80 children of both sex. 50 children (case group) collected from outpatient pediatric hepatology clinic of Benha University hospitals and National Liver Institute Monoufia University. 30 apparently healthy children (control group) matched the patient group in age and sex. All children subjected to full history taking, physical examination and Laboratory Investigations: CBC, AST, ALT, GGT, alkaline phosphatase, serum bilirubin, serum albumin, PT, PTT, INR, total protein, total serum IgG levels, hepatitis markers (HAV, HBV&HCV), liver biopsy and serum autotaxin level by ELISA. There was statistical significant difference (P value <0.01) among chronic hepatitis group and control group regarding HB, platelet, total protein as they were lower in chronic hepatitis group than control group, while PT, INR, AST, ALT, GGT, ALP and bilirubin (total& direct) were higher in chronic hepatitis group than control group.There was statistical significant differencebetween studied groups regarding serum autotaxin as it was elevated in chronic hepatitis group. There were statistical significant differences between serum level of autotaxin and fibrosis index, hepatitis activity index and interface hepatitis as it increases with increase fibrosis index, hepatitis activity index and interface hepatitis. The best cut off value of serum autotaxin was 10.45ng/ml for detection of early fibrosis stage with sensitivity 97.6%, specificity 93.8% and area under the curve is 0.961 while the best cut off serum autotaxin for detection of moderate fibrosis was 18.15ng/ml with sensitivity 85%, specificity 93.8% and area under the curve is 0.984. Autotaxin may be a novel non-invasive biomarker for liver fibrosis done on Egyptian children with chronic hepatitis.

Key words

Chronic hepatitis, Liver fibrosis, Autotaxin.