Cytokeratin 18 as marker for non-invasive diagnosis of acute liver diseases

Background: Assessment of CK-18 cell death biomarkers allows for the early detection of liver damage in acute liver diseases. Our aim of work is to prove that CK-18 cell death biomarkers in serum enables early detection of liver damage in acute liver diseases. Patients and methods: a cross sectional study that conducted. It included 40 child with acute liver disease and compared to 25 age and sex matched childen as a control group who presented at outpatient clinics and inpatient departments in Beni-Suef university hospital. All patients underwent complete history taking, complete physical examination and investigations including Alanine Aminotransferase, Aspartate Transaminas, Albumin, CBC, CRP, Urea ,creatinine and Serum CK -18 measurement using ELISA kit. Results: CK18 levels were significantly higher in liver disease patients than controls. There was significantly difference between the studied groups regarding their CK18 level. There was insignificant correlation between CK18 and labs in Acute Hepatitis. There was a significant positive correlation between CK18 and INR in fulminant hepatitis. When ROC curve was plotted, CK18 was found to have a significant role in diagnosing of liver disease as Acute Hepatitis and Fulminant Hepatitis with reasonable sensitivity, specificity, PPV, NPV. Conclusion and recommendations: CK18 may help in diagnosis of liver diseases in children. Further multicenter studies on a large number of populations with serial measurements of CK18 levels are recommended to further evaluate the role of CK18 in the diagnosis of liver disease in children and to detect the prognostic value of CK18 regarding mortality.