Study Of Serum Alanine Transaminase: Serum Lactate Dehydrogenase Ratio for Typhoid Hepatitis
Keywords:
Typhoid hepatitis, viral hepatitis, S.ALT:S.LDH ratioAbstract
Introduction: Typhoid hepatitis clinically mimics acute viral hepatitis. Differentiation between these two illnesses is very important as typhoid hepatitis requires definitive treatment in form of antimicrobial drugs. This study was undertaken to study pattern of hepatic involvement in enteric fever and to evaluate serum ALT:LDH ratio for differentiating it from acute viral hepatitis.
Material and Method :This was a clinical observational study .Patients of enteric fever with hepatic manifestations were investigated with special reference to liver function tests, serum LDH and serum S ALT: S. LDH ratio. Results of these were compared with investigations of confirmed cases of viral hepatitis.
Result: Values of S.ALT, S.LDH and S.ALT:S.LDH were 121-1170 (mean 293±266), 150-2150 (mean 677±543) and 0.07-3.5 (0.52±0.5) respectively in enteric hepatitis, while in viral hepatitis were 580-2280 (1320±293), 290-1180 (445±180) and 4.5-87.2 (40±15) respectively. There is much more alteration of S.ALT level in patient of viral hepatitis as compared to typhoid hepatitis (p<0.05) and levels of LDH are more raised in patients of typhoid hepatitis as compared to viral hepatitis (p <0.05).So,the values of S.ALT:LDH ratio are higher in acute viral hepatitis as compared to enteric hepatitis (p<0.05).
Conclusion: S.ALT:S.LDH ratio´s cut off value of 4 can be used to differentiate between viral and Typhoid hepatitis.
References
A Parthsarathi.IAP text book of pediatric infectious dis-ease,1 st edition, Gwalior :JAYPEE Publisher;2013.p 218.
Kliegman, Stanton, St. Geme et al. Nelson Textbook of Pediatrics, 20th edition, Milwaukee: Elsevier Publication; 2016.p 1382.
El-Nehiwi HM, Alamy ME, Reynolds TB. Salmonella hepatitis analysis of 27 cases and comparison with acute viral hepatitis. Hepatology. 1996; 24(3):516-519.
Gurkan F, Derman O et al. Distinguishing features of salmonella and viral hepatitis. Pediatric infectious Dis-ease J 2000;19(6) :p587.
Ananthnarayan And Paniker. textbook of microbiology, 9th edition. Hyderabad: Universities Publication;2013. p298-299.
Malik AS. Complications of bacteriologically confirmed typhoid fever in children. J Trop Pediatric 2002;48:102-108.
S.Balasubramanian et al., study of serum ALT:LDH ratio in Typhoid fever and acute viral hepatitis. Indian pediatric journal 2010; 47:p339- 341
Fumagalli G. Behaviour of lactate dehydrogenase in ty-phoid infection. Minerva Med 1977;68:1199-1204.
Das D, Mandal SK et al.serum ALT:LDH ratio in ty-phoid hepatitis and acute viral hepatitis. J. Assoc Phy India 2003;51:p241.
Khosla S,Singh R et al.The spectrum of hepatic injury in enteric fever.Postgraduate med J.1990;66:p923.
Ahmed A,Ahmed B.Jaundice in typhoid pa-tients:Differntiation from other common causes of fever and jaundice in tropics.Ann Afr Med2010;9;135-40.
Nasrullah SM,Nasser VH.Enteric fever.Am J Gasteroen-terology;1978;69:63-9.
Moragateran R,Hayes pc.The liver in typhoid fe-ver:always affected not just a complication.Am J Gas-teroenterology.1991;86:1235-9.
Cassidy WM,Reynolds TB. Serum lactate dehydrogen-ase in the differential diagnosis of acute hepatocellular injury.J Clin Gastroenterol 1994;19:118-121.
Shetty AK,Mital SR,Baharinwala AH,khubchandani RP,Kumta NB.Typhoid hepatitis in children.j Trop Pe-diatic.1999;45:287-90
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