Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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The Relationships between Respiratory Virus Infection and Aminotransferase in Children

  • Oh, Jun Suk (Department of Pediatrics, Konyang University College of Medicine) ;
  • Choi, Jun Sik (Department of Pediatrics, Konyang University College of Medicine) ;
  • Lee, Young Hyuk (Department of Pediatrics, Konyang University College of Medicine) ;
  • Ko, Kyung Og (Department of Pediatrics, Konyang University College of Medicine) ;
  • Lim, Jae Woo (Department of Pediatrics, Konyang University College of Medicine) ;
  • Cheon, Eun Jung (Department of Pediatrics, Konyang University College of Medicine) ;
  • Lee, Gyung Min (Department of Pediatrics, Konyang University College of Medicine) ;
  • Yoon, Jung Min (Department of Pediatrics, Konyang University College of Medicine)
  • Received : 2016.07.24
  • Accepted : 2016.09.24
  • Published : 2016.12.30
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Abstract

Purpose: We sought to examine the relationship between the clinical manifestations of nonspecific reactive hepatitis and respiratory virus infection in pediatric patients. Methods: Patients admitted to the pediatric unit of Konyang University Hospital for lower respiratory tract disease between January 1, 2014 and December 31, 2014 and who underwent reverse transcriptase polymerase chain reaction tests were examined. The patients were divided into those with increased levels of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) and those with normal ALT or AST levels. Further, patients with increased ALT and AST levels were individually compared with patients in the normal group, and the blood test results were compared according to the type of respiratory virus. Results: Patients with increased ALT or AST levels had one more day of hospital stay, on average, compared with patients in the normal group ($5.3{\pm}3.1$ days vs. $4.4{\pm}3.0$ days, p=0.019). Patients in the increased ALT level group were younger and had a longer mean hospital stay, compared with patients in the normal group (p=0.022 and 0.003, respectively). The incidences of increased ALT or AST were the highest in adenovirus infections (6/24, 25.0%), followed by enterovirus (2/11, 18.2%) and respiratory syncytial virus A (21/131, 16.0%) infections. Conclusion: Nonspecific reactive hepatitis is more common among patients with adenovirus, enterovirus and respiratory syncytial virus infection, as well as among those infected at a younger age. Compared with AST levels, ALT levels are better indicators of the severity of nonspecific reactive hepatitis.

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References

  1. Squires JE, Balistreri WF. Manifestations of liver disease. In: Kliegman RM, Stanton BF, St. Geme JW III, Schor NF, eds. Nelson textbook of pediatrics. 20th ed. Canada: Elsevier, 2016:1926.
  2. Steigmann F, Szanto PB, Meister HP, Pamukcu F. Clinical significance of nonspecific (reactive) hepatitis. Am J Gastroenterol 1965;44:129-37.
  3. Schaffner F, Popper H. Nonspecific reactive hepatitis in aged and infirm people. Am J Dig Dis 1959;4:389-99. https://doi.org/10.1007/BF02231171
  4. Kim TS, Hur TH, Lim SJ, Bin JH, Hahn SH, Kim SY, et al. A rise and fall in AST and ALT level in nonspecific reactive hepatitis. Korean J Pediatr 2008;51:396-400. https://doi.org/10.3345/kjp.2008.51.4.396
  5. Jung BS, Oh JS, Cho B, Kim HH, Lee JS. A clinical study of respiratory tract infection in hospitalized children. Pediatr Allergy Respir Dis 1996;6:60-3.
  6. Elliot SP, Ray CG. Viral infections of the lower respiratory tract. In: Taussig LM, Landau LI, eds. Pediatric respiratory medicine. 2nd ed. Philadelphia: Mosby Elsevier Co., 2008:481-9.
  7. Lim JS, Woo SI, Kwon HI, Baek YH, Choi YK, Hahn YS. Clinical characteristics of acute lower respiratory tract infections due to 13 respiratory viruses detected by multiplex PCR in children. Korean J Pediatr 2010;53:373-9. https://doi.org/10.3345/kjp.2010.53.3.373
  8. Radcke S, Dillon JF, Murray AL. A systematic review of the prevalence of mildly abnormal liver function tests and associated health outcomes. Eur J Gastroenterol Hepatol 2015;27:1-7. https://doi.org/10.1097/MEG.0000000000000233
  9. Gahagan S. Overweight and obesity. In: Kliegman RM, Stanton BF, St. Geme JW III, Schor NF, eds. Nelson textbook of pediatrics. 20th ed. Canada: Elsevier, 2016:307.
  10. Polakos NK, Cornejo JC, Murray DA, Wright KO, Treanor JJ, Crispe IN, et al. Kupffer cell-dependent hepatitis occurs during influenza infection. Am J Pathol 2006;168:1169-78. https://doi.org/10.2353/ajpath.2006.050875
  11. Jeon NL, Kim BS, Kim YK, Hong SJ. Etiology and clinical features of severe acute viral lower respiratory tract infections in children. J Korean Pediatr Soc 2000;43:1558-68.
  12. Eisenhut M, Thorburn K. Hepatitis associated with severe respiratory syncytial virus-positive lower respiratory tract infection. Scand J Infect Dis 2002;34:235. https://doi.org/10.1080/00365540110077191
  13. Eisenhut M, Thorburn K, Ahmed T. Transaminase levels in ventilated children with respiratory syncytial virus bronchiolitis. Intensive Care Med 2004;30:931-4. https://doi.org/10.1007/s00134-004-2236-2
  14. Gopal DV, Rosen HR. Abnormal findings on liver function tests. Interpreting results to narrow the diagnosis and establish a prognosis. Postgrad Med 2000;107:100-2, 105-9, 113-4.
  15. Cohen JA, Kaplan MM. The SGOT/SGPT ratio--an indicator of alcoholic liver disease. Dig Dis Sci 1979;24:835-8. https://doi.org/10.1007/BF01324898
  16. Brumbaugh D, Mack C. Conjugated hyperbilirubinemia in children. Pediatr Rev 2012;33:291-302. https://doi.org/10.1542/pir.33-7-291
  17. Appenzeller C, Ammann RA, Duppenthaler A, Gorgievski-Hrisoho M, Aebi C. Serum C-reactive protein in children with adenovirus infection. Swiss Med Wkly 2002;132:345-50.
  18. Kim KM. Paper presented at: 2010 Spring Symposium, 2010; Seoul, Korea. p. 70-6.

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