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Differential Diagnoses

 Breast Milk Jaundice


 Cholestasis: reduced or blocked flow of bile from liver to duodenum
 Dubin-Johnson Syndrome: increased conjugated bilirubin in serum causing black
liver, hepatocyte cannot secrete bilirubin into bile
 Galactose-1-Phosphate Uridyltransferase Deficiency (Galactosemia): inability to
metabolize galactose
 Hepatitis B
 Pediatric Biliary Atresia
 Pediatric Cytomegalovirus Infection: not a problem unless pregenant or weak immune
system, can be passed down, premature birth, low birth weight, jaundice, enlarged &
poorly functioning liver
 Pediatric Duodenal Atresia
 Pediatric Hypothyroidism

Galactose-1-phosphate uridyltransferase (GALT) is an enzyme that converts the simple sugar


galactose to glucose, Low levels of GALT, galactokinase GALK, and uridine diphosphate galactose-4-
epimerase GALE limits the body’s ability to metabolize galactose. This causes galactose accumulation
in red blood cells, which leads to a condition known as galactosemia. A low value (less than 14.7
U/g of hemoglobin) for the GALT Blood Test may indicate galactosemia. Individuals with
galactosemia must start a galactose-restricted diet as soon as possible. Foods, such as dairy
products, should be avoided, as the lactose they contain is broken down into glucose and
galactose

The aPTT test is used to measure and evaluate all the clotting factors of the intrinsic and common
pathways of the clotting cascade by measuring the time (in seconds) it takes a clot to form after
adding calcium and phospholipid emulsion to a plasma sample.

Partial thromboplastin time (PTT) and activated partial thromboplastin time (aPTT) are used
to test for the same functions; however, in aPTT, an activator is added that speeds up the
clotting time and results in a narrower reference range. The aPTT is considered a more
sensitive version of the PTT and is used to monitor the patient’s response to heparin therapy.

The reference range of the aPTT is 30-40 seconds.

The reference range of the PTT is 60-70 seconds.

Critical values that should prompt a clinical alert are as follows:

 aPTT: More than 70 seconds (signifies spontaneous bleeding)


 PTT: More than 100 seconds (signifies spontaneous bleeding)

aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT). These
enzymes are normally predominantly contained within liver cells and to a lesser degree in the
muscle cells. If the liver is injured or damaged, the liver cells spill these enzymes into the blood,
raising the AST and ALT enzyme blood levels and signaling liver disease.

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