Distribution of Diseases Causing Liver Function Test Abnormality in Children and Natural Recovery Time of the Abnormal Liver Function

Abstract

Although liver function test abnormality is frequently noted in children, there is no report about the distribution of the etiology and natural recovery time of the abnormal liver function. From March 2005 to February 2014, clinical information was retrospectively collected from 559 children who had abnormal liver function and were hospitalized or visited the outpatient clinic at the Jeju National University Hospital. The etiology of abnormal liver function was classified into groups and the natural recovery time of abnormal liver function was analyzed. The etiological groups of 559 patients included ‘nonspecific hepatitis’ in 42 (7.5%), ‘infection’ in 323 (57.8%), ‘rheumatologic and autoimmune’ in 66 (11.8%), ‘nonalcoholic fatty liver disease’ in 57 (10.2%), ‘anatomic’ in 12 (2.1%), ‘toxic’ in 13 (2.1%), ‘metabolic’ in 8 (1.4%), ‘hematologic’ in 7 (1.3%), ‘hemodynamic’ in 4 (0.7%), and ‘others’ in 27 (4.8%). Among the ‘infection’ group (57.8%), the ‘viral infection in the respiratory tract’ subgroup, which had 111 patients (19.8%), was the most common. The natural recovery time of the abnormal liver function was 27 days (median) in ‘nonspecific hepatitis’, 13 days (median) in ‘viral respiratory tract disease’, 16 days (median) in ‘viral gastroenteritis’, 42 days (median) in ‘viral febrile illness”, and 7 days (median) in “Kawasaki disease”. The information on the natural recovery time of abnormal liver function may help the physician to perform good clinical consultation for patients and their parents.

Clinical Characteristics, Prognostic Factors, and Real-World Practice of Abnormal Liver Function Tests in Children with Acute Infectious Diseases: A Multicenter Study

“…Respiratory infection was the most common diagnosis, and rhinovirus was the most common pathogen in our study. Previous Korean studies also reported that respiratory infection was the most common infection focus in NRH; however, adenovirus and respiratory syncytial virus were more common than rhinovirus (2,4). Some case reports also show that these respiratory viruses can cause liver injury during systemic infection (5)(6)(7)(8)(9)(10).…”

“…Systemic infection-related liver enzyme elevation in children is a common clinical situation (2,4). Although hepatic enzymes are increased in various diseases such as sepsis, respiratory infections, digestive diseases, and urinary tract infections, the clear mechanism of liver injury after systemic infection is still unknown (1).…”

“…An abnormal liver function test (LFT) is commonly observed in pediatric patients with acute infectious diseases such as respiratory tract infections, gastroenteritis, and urinary tract infections (1,2). Most patients only show modest aspartate aminotransferase (AST) and alanine aminotransferase (ALT) elevation; however, some patients might have more severe hepatic injuries showing other LFT abnormalities such as elevated bilirubin levels, prolonged prothrombin time, and hypoalbuminemia (1).…”

“…Some pathogens, such as tuberculosis, Campylobacter, Clostridium perfringens, cytomegalovirus (CMV), and herpes virus could cause not only transient abnormal LFTs but also acute liver failure and hepatic encephalopathy (1). This condition is usually self-limiting; however, sometimes it can persist for longer than a year, which could annoy parents and physicians (2). The exact pathophysiology of liver involvement in systemic infection is not well known; it can induce hepatic injury through direct invasion, indirect toxin-induced injury, or cytokines (1).…”

Hepatoprotective activity of okra (Abelmoschus esculentus L.) in sodium nitrite-induced hepatotoxicity

“…In the liver, this can be seen by observing the number of necrotic cells and can also be identified using biochemical markers. The biochemical features of liver damage include the production of serum alanine aminotransferase (ALT) and serum aspartate aminotransferase (AST) enzymes [ 4 ]. Oxidative stress-induced by sodium nitrite can be overcome by antioxidants [ 5 , 6 ].…”