Alpha fetoprotein in the differentiation of neonatal hepatitis and biliary atresia: current status and implications for the pathogenesis of these disorders.

Neonatal hepatitis (NH) and biliary atresia (BA) are disorders of early infancy that may be difficult to differentiate. Since surgical therapy can be curative if performed early in the disease course of BA, accurate diagnosis is of great importance. Elevated levels of serum alpha fetoprotein (AFP) do occur in many cases of NH and may be helpful in differentiating this condition from BA. Evidence is presented which suggests that initially BA and NH may be the same disease. The individual host response determines the final clinical outcome and AFP could be the immunoregulatory substance which affects pathological progression from NH to BA.