Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
권호 표지
DOI QR코드

DOI QR Code

Increase in Aminotransferase Levels during Urinary Tract Infections in Children

  • Park, Ju Yi (Department of Pediatrics, Konyang University College of Medicine) ;
  • Ko, Kyung Ok (Department of Pediatrics, Konyang University College of Medicine) ;
  • Lim, Jae Woo (Department of Pediatrics, Konyang University College of Medicine) ;
  • Cheon, Eun Jeong (Department of Pediatrics, Konyang University College of Medicine) ;
  • Yoon, Jung Min (Department of Pediatrics, Konyang University College of Medicine)
  • Received : 2013.06.06
  • Accepted : 2013.06.18
  • Published : 2013.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The aim of this study was to evaluate the prevalence of increased aminotransferase levels and to identify associated factors in children admitted to hospital with urinary tract infections (UTIs). Methods: The study included children with a diagnosis of UTI who were admitted to the Konyang University Hospital from January 2007 to May 2011. The total number of patients was 249 and the mean age was $15.88{\pm}28.21$ months. UTI was defined as a positive urine culture (> $10^5$/colony forming unit [CFU]) with pyrexia. Patients were treated by intravenous antibiotics, such as ampicillin/sulbactam, aminoglycoside, cephalosporins or vancomycin. Patients with neonatal jaundice or other liver disease were excluded. We investigated the relationship of aminotransferase levels with the type of antibiotic, degree of vesicoureteral reflux (VUR), and causative organisms. Results: Children with increased aminotransferase levels were younger than those with normal levels (p=0.001), but white blood cell count, platelet count, causative organisms, type of antibiotics and presence of VUR were not associated with aminotransferase levels. Aminotransferase levels became normal within 1 month after discharge without special measures, except in 1 case. Conclusion: We found that many children with UTI have abnormal aminotransferase levels. In most cases, this change is mild and self-limiting. We conclude that increased aminotransferase level increase during UTI do not require unnecessary tests and excessive treatment.

Keywords

References

  1. Pastor CM, Billiar TR, Losser MR, Payen DM. Liver injury during sepsis. J Crit Care 1995;10:183-97. https://doi.org/10.1016/0883-9441(95)90010-1
  2. Szabo G, Romics L Jr, Frendl G. Liver in sepsis and systemic inflammatory response syndrome. Clin Liver Dis 2002;6:1045-66. https://doi.org/10.1016/S1089-3261(02)00058-2
  3. Van Oosten M, Rensen PC, Van Amersfoort ES, Van Eck M, Van Dam AM, Breve JJ, et al. Apolipoprotein E protects against bacterial lipopolysaccharide-induced lethality. A new therapeutic approach to treat gram-negative sepsis. J Biol Chem 2001;276:8820-4. https://doi.org/10.1074/jbc.M009915200
  4. Naito M, Hasegawa G, Ebe Y, Yamamoto T. Differentiation and function of Kupffer cells. Med Electron Microsc 2004;37:16-28. https://doi.org/10.1007/s00795-003-0228-x
  5. Klatskin G. Hepatitis associated with systemic infections. In: Zakim D, Boyer TD, eds. Hepatology: a textbook of liver disease. Philadelphia: WB Saunders, 1982:711-3.
  6. Burkitt HG, Young B, Heath JW. Wheater's functional histology: a text and colour atlas. 3rd ed. Edinburgh: Churchill Livingstone, 1993.
  7. Giannini EG, Testa R, Savarino V. Liver enzyme alteration: a guide for clinicians. CMAJ 2005;172:367-79. https://doi.org/10.1503/cmaj.1040752
  8. Dahn MS, Lange P, Lobdell K, Hans B, Jacobs LA, Mitchell RA. Splanchnic and total body oxygen consumption differences in septic and injured patients. Surgery 1987;101:69-80.
  9. Dhainaut JF, Marin N, Mignon A, Vinsonneau C. Hepatic response to sepsis: interaction between coagulation and inflammatory processes. Crit Care Med 2001;29(7 Suppl):S42-7. https://doi.org/10.1097/00003246-200107001-00016
  10. Marshall JC. Inflammation, coagulopathy, and the pathogenesis of multiple organ dysfunction syndrome. Crit Care Med 2001;29(7 Suppl):S99-106. https://doi.org/10.1097/00003246-200107001-00032
  11. Chand N, Sanyal AJ. Sepsis-induced cholestasis. Hepatology 2007;45:230-41. https://doi.org/10.1002/hep.21480
  12. Vermillion SE, Gregg JA, Baggenstoss AH, Bartholomew LG. Jaundice associated with bacteremia. Arch Intern Med 1969;124:611-8. https://doi.org/10.1001/archinte.1969.00300210093014
  13. Moseley RH. Sepsis and cholestasis. Clin Liver Dis 1999;3:465-75. https://doi.org/10.1016/S1089-3261(05)70080-5
  14. Neale G, Caughey DE, Mollin DL, Booth CC. Effects of intrahepatic and extrahepatic infection on liver function. Br Med J 1966;1:382-7. https://doi.org/10.1136/bmj.1.5484.382
  15. Campos J, Alende R, Gonzalez-Quintela A. Abnormalities in aminotransferase levels during acute pyelonephritis. Eur J Intern Med 2009;20:e53-6. https://doi.org/10.1016/j.ejim.2008.04.003
  16. File TM Jr, Tan JS, Salstrom SJ. Clinical evaluation of ceftriaxone. Clin Ther 1984;6:653-61.

Cited by

  1. Association between Elevated Alanine Aminotransferase and Urosepsis in Children with Acute Pyelonephritis vol.19, pp.1, 2013, https://doi.org/10.5223/pghn.2016.19.1.54
  2. Poor efficacy of preemptive amoxicillin clavulanate for preventing secondary infection from Bothrops snakebites in the Brazilian Amazon: A randomized controlled clinical trial vol.11, pp.7, 2013, https://doi.org/10.1371/journal.pntd.0005745
  3. A Multicenter Study of Real-world Practice for Management of Abnormal Liver Function Tests in Children with Acute Infectious Diseases vol.36, pp.47, 2013, https://doi.org/10.3346/jkms.2021.36.e310