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Simplifying, Expediting Biliary Atresia Diagnosis, with Ahmad Anouti, MD
Anouti discusses the new AAP biliary atresia guidance and what it means to him as a patient-advocate who had biliary atresia as an infant.
Recent guidance from the American Academy of Pediatrics (AAP) is helping facilitate the early identification of biliary atresia in infants, providing pediatric primary care providers with a novel strategy to simplify and expedite the process.
Intended to be used between 2 and 4 weeks of life at the “By 1 month” well-child visit in the Bright Futures/AAP “Recommendations for Preventive Pediatric Health Care,” the strategy involves examining infants’ eye color, stool color, and prior laboratory results to determine whether measurement of a direct or conjugated bilirubin level is warranted.
Biliary atresia is estimated to impact 1 in 8,000 to 1 in 18,000 live births worldwide, with symptoms typically appearing between 2 and 6 weeks after birth. The trapped bile can quickly cause liver damage and cirrhosis, eventually leading to liver failure, but outcomes can be improved with early diagnosis and surgery.
“The key here is to catch it early and catch it fast,” Ahmad Anouti, MD, a pediatric resident at the University of Texas Southwestern in the Physician Scientist Training Program, explained to HCPLive. “If we do, the success and the outcomes have been proven time and time again to be better."
Anouti emphasized the importance of the strategy provided by the recent AAP guidance, citing frequent overcomplication in medicine as a whole when it comes to diagnoses and testing. For biliary atresia, he noted the step-by-step guide provided by AAP can simplify the diagnostic process for any primary pediatrician, ideally expediting linkage to a hepatologist.
In addition to being a medical doctor, Anouti is also a patient advocate. Having been diagnosed with biliary atresia as a child and eventually requiring a liver transplant after receiving a late Kasai procedure when he was about 77 days old, Anouti told HCPLive he wishes the AAP guideline had existed when he needed it as a child.
“With a guideline like this and with an approach like this, the answers come quicker and the treatment comes quicker,” he explained. “As a patient and as a resident in training, it's really eye-opening to see how much these minutes or days or months impact the patient's life, decrease the anxiety, make the answers come quicker, and really make the patient feel like this is being taken seriously and not dragging on.”
Anouti went on to describe how he considers himself to be a patient before a doctor, and the unique perspective this equips him with during his research and clinical work.
“It's very humbling and very exciting to see guidelines like this come out, because it shows me how the field is pushing forward,” he said.
Editors’ note: Anouti has no relevant disclosures.
