소아 인플루엔자 입원 환자에서 나타난 고아미노전이효소혈증의 임상적 특성

Abstract

Purpose: Hypertransaminasemia in childhood influenza has been reported as an uncommon feature and there were a few domestic studies for it. I did this study to know its update clinical characteristics and significance. Methods: I collected clinical informations of influenza patients who had been diagnosed and admitted at the Department of Pediatrics, Yogin Severance Hospital from January 2014 to April 2017. Influenza infection was decided by rapid antigen test from nasopharyngeal swab. They were divided into group A (who had hypertransaminasemia) and group B (who had not it). Their clinical features were investigated and compared. Results: There were 72 cases (57.6%) for group A and 53 cases (42.4%) for group B. In group A, 4 cases showed serum concentration elevation of both of alanine aminotransferase and aspartate aminotransferase (AST) above normal range. There was no group A case without AST elevation. Ages of group A and group B were 51.5±38.6 months old and 87.2±48.5 months old, respectively ( P <0.001). Proportions of the patients being younger than 3 years old were 44.4% for group A and 15.1% for group B ( P <0.001). Male to female ratios were 1:1.7 for group A and 1:1.1 for group B. Their clinical manifestations regarding to composition ratios of antigenic type, durations of fever, frequency of cough, sputum, abdominal pain, vomiting, diarrhea, nausea, lethargy, lower respiratory tract involvements did not showed any significant difference between the two groups except rhinorrhea (81.9% for group A and 71.7% for group B, P =0.042). Their admission durations were comparable with each other (3.4±1.4 days for group A and 3.2±1.1 days for group B). Regarding to laboratory findings, group A showed higher absolute lymphocyte counts and serum potassium levels and lower creatinine level than group B. Among cases with elevated C- reactive protein concentration, group A had more severe cases (>5 times than normal) than group B (45.2% for group A vs. 16.0% for group B, P =0.020). Conclusion: Hypertransaminasemia in hospitalized childhood influenza is not uncommon and usually found in very young patients. Although it does not impact on their short term prognosis, that should be kept in mind for physician who care them. Further multi-hospital based investigation should be done to confirm these conclusion.