Elevated Liver Transaminase Levels in Children With Blunt Abdominal Trauma: A Predictor of Liver Injury

Hennes, Halim M.; Smith, Douglas S.; Schneider, Kathleen; Hegenbarth, Mary; Duma, Michael A.; Jona, Juda Z.

doi:10.1542/peds.86.1.87

Cited by 82 publications

(5 citation statements)

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“…The increase of blood ALT is associated with a series of liver dysfunction problems including liver injury and infection of viral hepatitis. 23 In the present study, administration of INH with RIF significantly increased serum ALT and AST, whereas treatment of Dendrobine (100 and 200 mg/kg) significantly decreased serum ALT and AST, indicating Dendrobine possessed liver protective effects. Consistent with these results, we also observed that Dendrobine (100 and 200 mg/kg) ameliorated liver histopathological changes induced by INH and RIF.…”

Section: Discussionsupporting

confidence: 49%

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Dendrobine attenuates isoniazid- and rifampicin-induced liver injury by inhibiting miR-295-5p

Zhang

Zhu

et al. 2020

Hum Exp Toxicol

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The present study aims to investigate the protective effects of Dendrobine and its underlying mechanisms on liver injury induced by isoniazid (INH) and rifampicin (RIF). A mouse model of liver injury was induced by intragastrically administration of 100 mg/kg INH and 100 mg/kg RIF for 14 days. The mice were intragastrically administrated with Dendrobine (50, 100, and 200 mg/kg) before the administration of INH and RIF. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined. Oxidative stress markers including glutathione, superoxide dismutase, and malondialdehyde in the liver were measured and liver histopathological examinations were performed. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) and Western blot were applied to determine the mRNA and protein expressions, respectively. Luciferase reporter assay was used to evaluate the interactions between miR-295-5p and CYP1A2. Dendrobine significantly decreased serum ALT and AST and inhibited the liver index and ameliorated the liver histological changes induced by INH and RIF. Besides, Dendrobine also regulated oxidative stress status in the liver by the regulation of CYP1A2. Moreover, mmu-miR-295-5p was identified to target CYP1A2 and to regulate the expression of CYP1A2. In summary, Dendrobine ameliorated INH and RIF induced mouse liver injury by miR-295-5p-mediated CYP1A2 expression.

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Section: Discussionsupporting

confidence: 49%

“…Both ALT and AST are commonly used markers for the evaluation of liver injury. 23,24 AST is responsible for the transferase of the amino group and is usually elevated due to liver dysfunction including liver cell infection or necrosis. 24 ALT is a transaminase enzyme widely used in the clinical examination for liver function tests.…”

Section: Discussionmentioning

confidence: 99%

Dendrobine attenuates isoniazid- and rifampicin-induced liver injury by inhibiting miR-295-5p

Zhang

Zhu

et al. 2020

Hum Exp Toxicol

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“…There were no signi cant differences in sex, age, and clinical symptoms between the mild and moderate-severe groups. The ALT, AST, ALP, and GGT levels signi cantly correlated with the severity of liver injury, while the TBil level did not differ signi cantly between the two groups, suggesting that transaminase was a predictor of the severity of liver injury [20][21][22][23]17]. Furthermore, 97 cases had been exposed to more than one type of implicated drug for the primary disease before the liver injury occurred.…”

Section: Discussionmentioning

confidence: 96%

Clinical characteristics of Chinese children with liver function test abnormalities: A single-center retrospective study

Wang,

Zhang

2023

Preprint

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Objectives: To study the clinical features of Chinese children with liver function test abnormalities to provide a reference for early clinical diagnosis and timely treatment. Methods: This retrospective single-center cohort study included 133 children with unknown liver function abnormalities, who were hospitalized from January 2020 to December 2021 at Taizhou municipal hospital, and analyzed their clinical characteristics, etiology, and prognosis. Results: Among the 133 children with abnormal liver function in this study, 68 were male (51.13%) and 65 were female (48.87%). The abnormal liver function was related to age, and it was most common in infants aged 0–12 months. Among the etiologies of the primary diseases, liver dysfunction caused by acute respiratory tract infection was the most common, followed by pathogenic infections, including virual, bacterial, mycoplasma, and chlamydia infections, with virual and bacterial infections being most common. Alanine aminotransferase was elevated in children with liver dysfunction, and the severity of liver dysfunction differed with different causes. Children with abnormal liver function only showed the manifestations of the primary disease. Sex and age did not affect abnormal liver function. Medical histories of implicated agents before hospital admission were reported in 72.39% of children; however, intrinsic etiologies were the main cause of abnormal liver function rather than the implicated agents. Conclusion This retrospective single-center cohort study showed that routine liver function testing in children is important, especially for infants aged <12 months. Intrinsic etiologies were the main cause of liver dysfunction, and other factors should be detected and treated early. The etiological and liver protection treatments can ensure effective prevention and treatment of liver injury.

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“…[ 18 ] In a study conducted among paediatric patients with BAT, none of them with normal hepatic transaminase levels had liver injury identifiable on computed tomography. [ 19 ]…”

Section: Discussionmentioning

confidence: 99%

Predicting and grading liver injury in the absence of computed tomographic imaging

Newton

Subramanyam

2023

Journal of Family Medicine and Primary Care

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A BSTRACT Background: Even developed countries lack computed tomography (CT) scan in rural areas. Availability, affordability and accessibility of CT scan play an important role in the management of blunt hepatic trauma. Materials and Methods: A descriptive observational study among 56 hepatic blunt trauma patients as Group 1 and 56 non-hepatic blunt trauma patients as Group 2 enrolled retrospectively. Observational analysis of presence of liver trauma, grades of liver injury (I–VI) and clinical course with the liver function tests are done. Results: Aspartate transaminase (AST) ( P = 0.02) and alanine transaminase (ALT) ( P = 0.003) levels were significantly elevated among Group 1. Significantly elevated levels in Group 1 than Group 2 of AST [467.5 (22–5097) vs. 95 (23–1780); P < 0.001] and of ALT [422 (28–1548) vs. 69 (20–727); P < 0.001] noted. Significant elevation of AST and ALT levels, as the AAST (American Association for the Surgery of Trauma) CT grade of liver injury increases, noted ( P = 0.001). Using the ROC curve analysis, the optimal cut-off values of AST and ALT were set at ≥467.5 U/L and ≥111.5 U/L, respectively. At this cut-off, AST had sensitivity 50%, specificity 91.7%, PPV 85%, NPV 66%, ALT had sensitivity 85.3%, specificity 86.1%, PPV 85.3% and NPV 86.1% for liver injury. Conclusion: ALT is more sensitive for liver injury. AST peak is seen in the immediate period. Combining clinical assessment, transaminase levels and Focused Assessment with Sonography in Trauma improves the sensitivity and specificity. Transaminase levels can vary with ethnicity and local epidemiological diseases; therefore, optimal cut-off levels should be established for local population. This would predict and grade the liver injury, helping in early decision-making and avoid wasting the golden hour in trauma.

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Elevated Liver Transaminase Levels in Children With Blunt Abdominal Trauma: A Predictor of Liver Injury

Cited by 82 publications

References 0 publications

Dendrobine attenuates isoniazid- and rifampicin-induced liver injury by inhibiting miR-295-5p

Dendrobine attenuates isoniazid- and rifampicin-induced liver injury by inhibiting miR-295-5p

Clinical characteristics of Chinese children with liver function test abnormalities: A single-center retrospective study

Predicting and grading liver injury in the absence of computed tomographic imaging

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