In neonatal cholestasis, if the serum gammaglutamyl transpeptidase is more than 600IU/L the most likely diagnosis is.

Ans. is 'd' i.e., Biliary atresia Most of the books are of the opinion that alkaline phosphatase and gamma glutamyl transpeptidase are two enzymes that are associated with biliary tract disease.Serum levels of these enzymes are usually increased in cholestasis or bile duct obstruction.But the problem in that, all of these books also add that they may also be increased in parenchymal disease or infiltrative or mass lesions of the liverIn the question only the value of Gamma glutamyl transpeptidase is given. Nothing is mentioned about the value of other enzymes.We cannot come to a conclusive diagnosis only by the level of Gamma glutamyl transpeptidaseBut still such a considerable elevation in the serum level of Gamma glutamyl transpeptidase i.e., 10 to 12 times its normal value points towards the diagnosis of biliary tract diseaseNote:- Normal value of serum Gamma glutamyl transpeptidase is - 10-40IU/L