Serum hyaluronic acid in healthy infants and children and its value as a marker of progressive hepatobiliary disease starting in infancy

Clin Chim Acta. 1993 Apr 16;215(1):29-39. doi: 10.1016/0009-8981(93)90246-z.


We have established reference ranges for the concentrations of hyaluronic acid in serum from 397 infants and children and measured serum hyaluronic acid at presentation and 1 year follow-up in 37 infants who presented with hepatobiliary disease in the first 6 months of life. In health, hyaluronic acid concentrations fell progressively from median (10-90 percentile) values of 93 micrograms/l (49-153) at 1-3 months of age to 20 micrograms/l (9-40) at 2-3 years and 16 micrograms/l (6-32) at 4-18 years. In patients at presentation, the hyaluronic acid concentration was raised in 11 of 15 with biliary atresia, 6 of 11 with alpha-1 antitrypsin deficiency and 6 of 11 with cryptogenic hepatitis of infancy. One year later, the 9 patients who developed progressive liver disease showed 2-6-fold increases in hyaluronic acid concentration while no increase was observed in the 28 with undetectable or mild disease. Increases in serum hyaluronic acid concentration appeared to be a better indicator of progressive liver disease in infancy than standard laboratory tests.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Biliary Atresia / blood
  • Biliary Tract Diseases / blood*
  • Child
  • Child, Preschool
  • Female
  • Hepatitis / blood
  • Humans
  • Hyaluronic Acid / blood*
  • Infant
  • Infant, Newborn
  • Liver Diseases / blood
  • Male
  • Reference Values
  • alpha 1-Antitrypsin Deficiency


  • Hyaluronic Acid