Sajedianfard S, Ataollahi M, Dehghani S M
Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran.
astroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Int J Organ Transplant Med. 2020;11(2):65-70.
Background: Wilson's disease (WD) is an autosomal-recessive hereditary liver disease affecting copper metabolism.
To test the diagnostic value of a questionnaire for the diagnosis of WD in pediatrics age group.
70 children with biopsy-proven diagnosis of WD and 70 without WD were included in the study. A modified questionnaire with 4 items was used for the diagnosis of WD. The results were then compared to the definite diagnosis made by pathology (the gold standard test).
The median (IQR) modified score in those with WD was 4 (4-5), significantly (p<0.001) higher than that calculated for the comparison group, which was 0 (0-1). The most appropriate cut-off value for the score was 2.5, corresponding to a sensitivity and specificity of 100%, and 98.6%, respectively. Using this cut-off value to classify 20 children with and without WD who underwent liver transplantation resulted in an accuracy of 100%.
The modified scoring system is a sensitive and specific diagnostic tool for the diagnosis of WD in children. This is especially important in regions with limited access to specific laboratory tests for the diagnosis of WD.
背景:威尔逊病(WD)是一种常染色体隐性遗传性肝病,影响铜代谢。
测试一份问卷对儿科年龄组WD诊断的价值。
研究纳入70例经活检确诊为WD的儿童和70例未患WD的儿童。使用一份包含4个项目的改良问卷进行WD诊断。然后将结果与病理确诊(金标准检测)进行比较。
WD患儿的改良评分中位数(四分位间距)为4(4 - 5),显著高于对照组(p<0.001),对照组为0(0 - 1)。评分的最合适截断值为2.5,对应灵敏度和特异度分别为100%和98.6%。使用该截断值对20例接受肝移植的患WD和未患WD的儿童进行分类,准确率为100%。
改良评分系统是诊断儿童WD的敏感且特异的诊断工具。这在获取WD特异性实验室检测受限的地区尤为重要。