الفهرس 
Anatomy of the biliary tractOnly 14 pages are availabe for public view
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Abstract
Biliary atresia is a neonatal obstructive cholangio-pathy characterized by a destructive, obliterative process affecting both the interahepatic and extrahepatic biliary tree that presents in the first months of life .The consequence of progressive inflammatory and sclerotic reaction is the development of obstructive jaundice.
The aim of this study is to investigate the role of IL-8 and IL-6 in the pathogenesis of biliary atresia and to evaluate their relation to the clinical outcome.
This study was conducted on 60 children attending the Pediatric Hepatology clinic and Outpatient clinic, Children’s Hospital, Faculty of medicine. Ain Shams University.
They were classified into, group (1) which included 20 patients with biliary atresia and group (2) which included 20 patients with interahepatic cholestasis .They were compared to each other and to a cohort of 20 normal healthy children served as a control group (3) .
They were subjected to detailed history taking, clinical examination and investigation in the form of (CBC with differential, liver function test, total & direct bilirubin, serum IL-6 and IL-8), abdominal ultrasonography and liver biopsy only for 35 patients.
Data collected, tabulated and statistically analyzed.
The results of this study revealed that:-
There was highly significant decrement of weight percentile reported in the group (1) and in the group (2) when compared with controls.
There were significantly higher levels of serum (TLC, lymphocytes, and neutrophilis) in group (1) and in group (2) when compared with controls, but there was no significant difference of these parameters between group (1) and group (2).
There was highly significant decrement of RBCs count in group (1) and in group (2) than in controls but there was no significant difference between group (1) and group (2) as regards RBCs count.
Significantly higher levels of (AST, GGT, total bilirubin) were found in group (1) when compared with group (2).
There were significantly higher levels of serum IL-6 and IL-8 in group (1) and in group (2) when compared with controls , while there were significantly higher levels of serum IL-6 and IL-8 in group (1) than in group (2) .
As regards abdominal ultrasound, there was significant increment of splenic size recorded in group (1) when compared with group (2).
As regards liver biopsy, severe fibrosis was significantly more frequent in group (1) than in group (2) ,while (mild and no fibrosis) were significantly more frequent in group (2) when compared with group (1) .
Preserved hepatic architecture was significantly more frequent in group (2) than in group (1), while distorted hepatic architecture was more frequent in group (1) when compared with group (2).
Inflammatory cellular infiltrate was more frequent in group (1) than in group (2), but absence of inflammatory cellular infiltrate was statistically more frequent in group (2) when compared with group (1).
There was positive correlation between levels of IL-8 and lymphocytes in group (1).
There was negative correlation between levels of IL-8 and albumin levels in group (1).
There was significantly higher levels of IL-6 in patients with severe fibrosis than patients with mild fibrosis in group (1), but there was no significant difference between the degree of fibrosis in liver biopsy and levels of IL-8 in the same group.
Outcome of group (1) was, 6(30%) patients became jaundice free, 10(50%) had persistent jaundice and 4(20%) patients died.
Outcome of group (2) was, 9(45%) patients became jaundice free, 11(55%) had persistent jaundice and there were no dead patients among this group.
There was highly significant levels of IL-8 in patients with persistent jaundice than patients free from jaundice in the group of biliary atresia.
It is concluded that measurements of serum IL-6 and IL8 levels may possibly serve as a parameter for determining disease severity and may be predictive of prognosis with respect to the progression of liver dysfunction in biliary atresia
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