소아 로타바이러스 위장관염에서 나타나는 고아미노전이효소혈증

Abstract

Purpose: Rotavirus (RV) infection can result in severe childhood gastroenteritis and its hepatic involvement is not uncommon. There is no recent domestic report for that since the introduction of RV vaccination. I did this study to know the update clinical features of hypertransaminasemia with childhood rotavirus gastroenteritis (RVGE) for proper care. Methods: I collected the clinical informations of RVGE patients who had been admitted at the Department of Pediatrics, Yogin Severance Hospital from January 2012 to December 2015. RV antigen from stool was detected with an immunochromatography. Their data were investigated and compared by the type of hypertransaminasemia. Results: Hypertransaminasemia was found in 52 cases(80%) among 65 RVGE patients. Fortytwo patients showed serum aspartate transaminase (AST) elevation without serum alanine transaminase (ALT) elevation (AST group) and 10 patients had both of ALT and AST elevation (ALT group), and there was no other type. The patients with hypertransaminasemia were younger ( P =0.002) and showed lower tCO2 titer ( P =0.001), higher titer of serum BUN ( P =0.004) and uric acid ( P =0.014) than patients without it (NL group), but no significant difference was found for admission duration between them. Both AST group and ALT group were significantly younger and showed lower tCO2 titer, higher titer of serum BUN and uric acid than NL group. ALT group was younger than AST group ( P =0.025) and that was the only significant difference between them. There was no significant difference for admission duration between the three groups. Serum titer of ALT was positively correlated with that of AST (r=0.517, P =0.0002). Conclusion: Hypertransaminasemia is common in childhood RVGE. ALT and AST elevation are more frequently found in patients with younger age, more serious dehydration. Although they are not associated with acute prognosis in RVGE, the hepatic involvement should be cautioned during the initial care.