Gupta et al proposed a score for distinguishing neonatal hepatitis from extrahepatic biliary atresia. The authors are from the All India Institute of Medical Sciences (AIIMS) in New Delhi.
Patient selection: neonate with signs of cholestasis
Parameters:
(1) age of the patient in weeks
(2) jaundice
(3) stool
(4) urine
(5) liver
Parameter
Finding
Points
age of the patient
< 6 weeks
2
> 6 weeks
1
jaundice
fluctuating, mild to moderate
2
severe (serum total bilirubin > 8 mg/dL)
1
stool
normal or light yellow
2
mostly clay colored
1
urine
normal or light yellow
2
mostly dark yellow
1
liver
soft and smooth
4
firm with sharp edge
1
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 5
• maximum score 12
• A score >= 10 indicates neonatal hepatitis.
• A score < 10 indicates extrahepatic biliary atresia.
Performance:
• The sensitivity was 92% and specificity 76%.
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