# Serum procalcitonin as a marker of neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD)

## TL;DR

This study shows that procalcitonin (PCT) is a highly effective biomarker for distinguishing neonatal intrahepatic cholestasis caused by citrin deficiency from other liver diseases.

## Contribution

The study identifies PCT as a novel and more effective diagnostic marker for NICCD compared to traditional inflammatory markers.

## Key findings

- PCT levels were significantly higher in NICCD patients than in cholestatic hepatitis patients.
- PCT showed high sensitivity (90.8%) and specificity (98.3%) for diagnosing NICCD.
- PCT levels decreased after NICCD treatment.

## Abstract

•PCT was a highly sensitive marker to differentiate NICCD from cholestatic hepatitis patients.•PCT was reduced when NICCD was treated.•PCT is a much more effective marker to differentiate NICCD than the inflammatory markers.

PCT was a highly sensitive marker to differentiate NICCD from cholestatic hepatitis patients.

PCT was reduced when NICCD was treated.

PCT is a much more effective marker to differentiate NICCD than the inflammatory markers.

Neonatal Intrahepatic Cholestasis (NICCD), as the early-age stage of Citrin deficiency involving liver dysfunction, lacks efficient diagnostic markers. Procalcitonin (PCT) has been identified as a biomarker for infection as well as various organ damage. This study aimed to explore the potential of PCT as a biomarker for NICCD.

In a single-center retrospective case-control study. Serum PCT concentrations before and after treatment of 120 NICCD patients, as the study group, were compared to the same number of cholestatic hepatitis patients, as the control group. The potential value of PCT to discriminate NICCD from control disease was further explored using Receiver Operating Characteristic (ROC) curve analysis and compared to those of other inflammatory markers.

There was a significantly higher level of PCT in NICCD patients than in the control group. PCT concentrations were only weakly correlated with neutrophil counts and CRP levels (p ˂ 0.05). At a cut-off value of 0.495 ng/mL, PCT exhibited a significantly higher diagnostic value compared to other inflammatory markers for discriminating NICCD from the control, with a sensitivity of 90.8 % and specificity of 98.3 %.

PCT might be used as an initial biomarker to discriminate children with NICCD from another hepatitis disease.