Evidence map›Paper›PMID 40776613›Full record

ArticleClinical and experimental pediatrics2025

Serum copper and ceruloplasmin levels as biomarkers reflecting liver fibrosis in children with autoimmune hepatitis.

Salma Abdel Megeed Nagi, Mai Ibrahim Elashmawy, Amany E Elashkar, Mohamed Zaeim Hafez, Ashraf A E Emara, Osama Mohammad Abdelhay, Albayoumi A B Fouda, Mohamed AbdelAziz Doma, Ahmad Mohamed Awad, Ahmed Mohammed Saba and 12 more

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Article in Clinical and experimental pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

22 authors.

Salma Abdel Megeed NagiFaculty of Medicine, King Salman International University, South Sinai, Egypt.
Mai Ibrahim ElashmawyClinical Pathology Department, National Liver Institute, Menoufia University, Shebin ElKom, Egypt.
Amany E ElashkarClinical Pathology Department, National Liver Institute, Menoufia University, Shebin ElKom, Egypt.
Mohamed Zaeim HafezMedical Physiology Department, Faculty of Medicine, Al-Azhar University (Assiut), Assiut, Egypt.
Ashraf A E EmaraMedical Physiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Osama Mohammad AbdelhayMedical Physiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Albayoumi A B FoudaMedical Physiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohamed AbdelAziz DomaMedical Biochemistry Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ahmad Mohamed AwadMedical Biochemistry Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Ahmed Mohammed SabaMedical Biochemistry Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Hesham Abdelrahman AhmedMedical Biochemistry Department, Faculty of Medicine, Al-Azhar University (Assiut), Assiut, Egypt.
Ahmed Mohamed Gad AllahForensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Al-Azhar University (Assiut), Assiut, Egypt.
Fatma Mahmoud AbdelraheemHistology and Cell Biology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
Mohamed A GadMedical Biochemistry Department, Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
Mohamad A SolimanMedical Histology and Cell Biology Department, Faculty of Medicine, Al-Azhar University (Assiut), Assiut, Egypt.
Tamer I AbdalrhmanMedical Histology and Cell Biology Department, Faculty of Medicine, Al-Azhar University (Assiut), Assiut, Egypt.
Khaled Hassaan AwadPediatric Department, Faculty of Medicine, Al-Azhar University (Assiut), Assiut, Egypt.
Ismael A K M El-LebedyPediatric Department, Faculty of Medicine, Al-Azhar University (Assiut), Assiut, Egypt.
Mostafa M AbdelnaserMedical Microbiology and Immunology Departments, Faculty of Medicine, Al-Azhar University (Assiut), Assiut, Egypt.
Mohammed Z Abdel KareemMedical Microbiology and Immunology Departments, Faculty of Medicine, Al-Azhar University (Assiut), Assiut, Egypt.
Marwa Fekry HassanEpidemiology and Preventive Medicine Department, National Liver Institute, Menoufia University, Menoufia, Egypt.
Shymaa Sobhy Menshawy KhalifaPediatrics Department, Faculty of Medicine, Menoufia University, Shebin ElKom, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinical, biochemical, histological, and immunological indicators are frequently used to diagnose autoimmune hepatitis (AIH), a chronic inflammatory liver disease affecting children. Wilson disease, which resembles AIH, is mainly evaluated using serum ceruloplasmin and copper levels. However, changes in these biomarkers have also been observed in AIH, raising the question of whether they could be useful for evaluating children with AIH. PURPOSE: When selecting a treatment plan and estimating the long-term prognosis of patients with AIH, assessing the liver fibrosis stage is crucial. It is also crucial to identify noninvasive indicators of liver fibrosis, for which ceruloplasmin has been suggested as a biomarker in several liver diseases. Therefore, this study aimed to investigate the potential significance of serum ceruloplasmin and copper levels for identifying liver fibrosis in children with AIH.

methodsOne hundred children with AIH treated at Menoufia University's National Liver Institute Pediatric Hepatology, Gastroenterology, and Nutrition Department were enrolled. The duration of the study was 5 years (February 2020 to February 2025). The patients' histopathological, radiographic, laboratory, and clinical data were collected. We used the revised score to diagnose AIH. A Beckman Coulter AU480 chemistry analyzer was used to measure serum copper, while an enzyme-linked immunosorbent assay was used to measure serum ceruloplasmin.

resultsSerum ceruloplasmin levels were considerably lower in patients with advanced fibrosis (F3-4) than in those without advanced fibrosis (F0-2) (P<0.001). However, in patients with extensive fibrosis, the serum copper levels were considerably elevated (P<0.001). Compared to serum copper level, which had an area under a curve of 0.939 (95% confidence interval [CI], 0.887-0.991; P<0.001) and a cutoff of >24.7 mg/dL (90.8% sensitivity, 66.9% specificity), ceruloplasmin level had an area under a curve of 0.945 (95% CI, 0.889-1.00; P<0.001), suggesting that it could be a useful tool for the detection of advanced liver fibrosis in children.

conclusionTo estimate the long-term prognosis of patients with AIH, it is crucial to assess liver fibrosis stage. It is crucial to identify noninvasive indicators of liver fibrosis, for which ceruloplasmin has been suggested as a biomarker. Therefore, serum copper and ceruloplasmin levels may provide important information for the identification of advanced liver fibrosis in children with AIH.

Indexed as

Autoimmune hepatitisCeruloplasminLiver fibrosisSerum copperWilson disease

Identifiers

PMID40776613
PMCPMC12590052

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