{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:36:26Z","timestamp":1772987786060,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,12,8]],"date-time":"2024-12-08T00:00:00Z","timestamp":1733616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,12,8]],"date-time":"2024-12-08T00:00:00Z","timestamp":1733616000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To investigate liver biochemistry in infants screened for biliary atresia (BA) at the time of hepatobiliary scintigraphy (HS) and to evaluate the effect of change in threshold for HS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Infants born from 2010 to 2021, who underwent HS &lt;6\u2009months postpartum for BA, were included and data sourced from electronic medical records. The change in threshold in 2018 from \u226520 (and\/or if conjugated bilirubin exceeds 20% of total bilirubin) to \u226517\u2009\u03bcM (regardless of total bilirubin) was evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the cohort of 635 infants, 48 had BA, 247 had AATD, and the remaining 343 were categorised as \u2018other\u2019. After the threshold adjustment, HS timing was unaffected (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.27), but the annual HS rate rose from 39 to 87, yet evaluations following the new guideline only accounted for 12%. All liver parameters were elevated in the BA group compared with the additional groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Amongst the 104 patients with non\u2010excretory HS, gamma\u2010glutamyl transferase (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and alanine aminotransferase (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) remained elevated for BA. The lowest conjugated bilirubin measured in BA children was 36\u2009\u03bcM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>After threshold change, HS use increased without earlier BA diagnostics, but most were not due to the new guideline. Alanine aminotransferase and gamma\u2010glutamyl transferase should be considered in BA diagnostics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apa.17536","type":"journal-article","created":{"date-parts":[[2024,12,8]],"date-time":"2024-12-08T23:54:31Z","timestamp":1733702071000},"page":"1143-1151","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Thresholds for conjugated hyperbilirubinaemia and hepatobiliary scintigraphy in biliary atresia: A 12\u2010year national follow\u2010up"],"prefix":"10.1111","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2507-2928","authenticated-orcid":false,"given":"Anna Kajsa G.","family":"Jessen","sequence":"first","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine Copenhagen University Hospital, Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3763-8839","authenticated-orcid":false,"given":"Thora W.","family":"Helt","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine Copenhagen University Hospital, Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars S.","family":"Johansen","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery Copenhagen University Hospital, Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rasmus N.","family":"Gaardsk\u00e6r","sequence":"additional","affiliation":[{"name":"Hans Christian Andersen Children's Hospital Odense University Hospital  Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5690-3725","authenticated-orcid":false,"given":"Christian","family":"Heiring","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care Copenhagen University Hospital, Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helene","family":"Kvistgaard","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Madsen","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine &amp; PET\u2010Centre Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane A.","family":"Simonsen","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Odense University Hospital  Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00f8ren","family":"M\u00f8ller","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine, Center for Functional and Diagnostic Imaging and Research Copenhagen University Hospital, Amager and Hvidovre  Copenhagen Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0890-3832","authenticated-orcid":false,"given":"Vibeke B.","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery Copenhagen University Hospital, Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Pediatrics and Adolescent Medicine Copenhagen University Hospital, Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Comparative Pediatrics and Nutrition Copenhagen University Hospital, Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lise","family":"Borgwardt","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine Copenhagen University Hospital, Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,8]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60946-6"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-057424"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001334"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2018.07.025"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0176275"},{"issue":"8","key":"e_1_2_13_7_1","article-title":"Hepatobiliary scintigraphy for early diagnosis of biliary atresia","volume":"63","author":"Brittain JM","year":"2016","journal-title":"Dan Med J"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnmt.110.082289"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.12067"},{"key":"e_1_2_13_10_1","article-title":"Sundhedsstyrelsens anbefalinger vedr. opsporing af galdevejsatresi","author":"Ebbesen F","year":"2003","journal-title":"Patientforl\u00f8bsprogram"},{"key":"e_1_2_13_11_1","unstructured":"DalbyK JohansenLS RasmussenA.Neonatal kolestase\/Konjungeret neonatal hyperbilirubin\u00e6mi.20181\/6\/2018 [cited 2021 16\/12]. 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