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Health

UPMC researchers find promise in test for shaken baby syndrome

Ben Schmitt
| Wednesday, April 12, 2017, 6:42 p.m.
UPMC converted the former St. Francis Medical Center campus in Lawrenceville to accommodate the expanded Children’s Hospital of Pittsburgh. The facility opened in May 2009.
Donald Koch
UPMC converted the former St. Francis Medical Center campus in Lawrenceville to accommodate the expanded Children’s Hospital of Pittsburgh. The facility opened in May 2009.

A new blood test developed by Children's Hospital of Pittsburgh of UPMC researchers shows promise in more accurately identifying infants suffering from bleeding of the brain, commonly known as shaken baby syndrome.

Shaken baby syndrome, or abusive head trauma, is the leading cause of death from traumatic brain injury in infants and the leading cause of death from physical abuse in the country, said Dr. Rachel Berger, chief of the Child Advocacy Center at Children's. Berger was senior author of a study about the new test published this week in the medical journal JAMA Pediatrics.

She said doctors miss about 30 percent of shaken baby cases. The reasons might be a caretaker who either intentionally or unintentionally gives false information or an infant presenting mild symptoms such as vomiting or irritability. Shaken baby syndrome occurs when adults violently shake youngsters.

The National Center on Shaken Baby Syndrome estimates that each year 1,200 to 1,400 babies die or are injured from being shaken.

“Missing a case of abusive head trauma is something which emergency department physicians fear because the next time the baby comes in, he or she may be dead,” Berger told the Tribune-Review. “Usually a fussy baby is just fussy because they have a virus or colic, but you want to rule out the most dangerous diagnosis for that symptom.”

In the current study, the researchers worked with Axela, a Canadian molecular diagnostics company, to develop a sensitive test that could reduce the chances of a missed diagnosis by using a combination of three biological characteristics along with a measure of the patient's level of hemoglobin, the protein that carries oxygen in blood. Axela's testing system allowed the researchers to measure several characteristics while using a small amount of blood, making the test easier to be used in infants.

Together, they created a formula for differentiating between infants with and without brain hemorrhage or brain bleeding. Those who test positive would subsequently be evaluated via CT scan to find the source of brain bleeding.

The study used stored blood samples from 599 infants between the ages of 30 days and a year.

Testing took place at three pediatric emergency departments: Children's, Primary Children's Hospital in Salt Lake City, Utah, and Lurie Children's Hospital in Chicago.

Berger said the new test detected bleeding in the brain 90 percent of the time

“This is for well-appearing babies with no history of trauma,” she said. “For example, when the baby comes in with fussiness, a physician would order the test before unnecessarily going right for a CT scan. The test is not meant to replace clinical judgment, but it is supposed to assist clinical judgment.”

Pitt, Berger and Axela have filed a joint U.S. patent for the test. More studies are needed before the test can be approved and implemented.

“This study illustrates the benefits of being able to perform highly sensitive tests at the point of care,” Paul Smith, president and CEO of Axela and a co-author of the study, said in a news release.

The National Institutes of Health funded the research.

Ben Schmitt is a Tribune-Review staff writer. Reach him at 412-320-7991 or bschmitt@tribweb.com.

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