Brief Reports
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2005; 11(35): 5553-5556
Published online Sep 21, 2005. doi: 10.3748/wjg.v11.i35.5553
Disproportional exaggerated aspartate transaminase is a useful prognostic parameter in late leptospirosis
Ming-Ling Chang, Chih-Wei Yang, Jeng-Chang Chen, Yu-Pin Ho, Ming-Jeng Pan, Cheng-Hui Lin, Deng-Yn Lin
Ming-Ling Chang, Yu-Pin Ho, Cheng-Hui Lin, Deng-Yn Lin, Department of Hepatogastroenterology, Chang Gung Memorial Hospital, 5 Fu-Shin Street, Kweishan, Taoyuan, Taiwan, China
Chih-Wei Yang, Department of Nephrology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, China
Jeng-Chang Chen, Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan, China
Ming-Jeng Pan, National Taiwan University, Taipei, Taiwan, China
Author contributions: All authors contributed equally to the work.
Supported by the Chang Gung Medical Research Project fund, No. CMRPG 33014
Correspondence to: Dr. Deng-Yn Lin, Department of Hepatogastr-oenterology, Chang Gung Memorial Hospital, 5 Fu-Shin Street, Kweishan, Taoyuan, Taiwan, China. kitty8210@yahoo.com
Telephone: +886-3-3281200-8227 Fax: +886-3-3288957
Received: January 5, 2005
Revised: February 15, 2005
Accepted: February 18, 2005
Published online: September 21, 2005
Abstract

AIM: To evaluate the hepatic dysfunction in leptospirosis is usually mild and resolved eventually. However, sequential follow-up of liver biochemical data remained lacking..

METHODS: The biochemistry data and clinical symptoms of 11 sporadic patients were collected and analyzed, focusing on the impacts of leptospirosis upon liver biochemistry tests.

RESULTS: The results disclosed that of the 11 cases, 5 or 45% died. The liver biochemistry data in the beginning of the disease course were only mildly elevated. Nevertheless, late exaggerated aspartate transaminase (AST) elevations were noted in three cases who finally died when compared with the typical course. Besides, significant higher AST/alanine transaminase (ALT) ratios (AARs) of the peak levels for transaminase were also noted in the cases who eventually succumbed. The mean±SD of AARs for the survival group and dead group were 5.652.27 (n = 5) and 1.860.64 (n = 6) respectively (P = 0.006). The ratios of the cases who finally died were all more than 3.0. Conversely, the survival group’s ratios were less than 3.0.

CONCLUSION: Serial follow-up of transaminase might provide evidence to predict some rare evolutions in leptospirosis. If AST elevated progressively without a concomitant change of ALT, it might indicate an acute disease course with ensuing death. Additionally, AAR is another prognostic parameter for leptospirosis. Once the value was higher than 3.0, a grave prognosis is inevitable.

Keywords: Leptospirosis; Liver; Aspartate transaminase; Alanine transaminase; AST/ALT ratios