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Hepatic dysfunction in pediatric scrub typhus: role of liver function test in diagnosis and marker of disease

Chulapong Chanta1, Krilerk Triratanapa, Preecha Ratanasirichup

  • 1Pediatric Unit, Chiang Rai Regional Hospital, Chiang Rai, Thailand.

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|January 10, 2008
PubMed

Insights

Liver function abnormalities are common in children with scrub typhus, with elevated AST and ALT levels correlating with disease severity. These liver function tests (LFTs) can aid in assessing scrub typhus severity.

Area of Science:

  • Pediatric Infectious Diseases
  • Hepatology
  • Microbiology

Background:

  • Scrub typhus, a zoonotic disease caused by Orientia tsutsugamushi, can lead to severe complications.
  • Hepatic involvement is a recognized manifestation of scrub typhus, but its frequency and correlation with disease severity in children require further elucidation.

Purpose of the Study:

  • To determine the incidence of liver function test (LFT) abnormalities in pediatric scrub typhus cases.
  • To investigate the relationship between LFT abnormalities and the clinical severity of scrub typhus in children.

Main Methods:

  • A study involving 54 children diagnosed with scrub typhus.
  • Diagnosis confirmed by indirect immunofluorescent antibody (IFA) titers.
  • Liver function tests (serum AST, ALT, albumin, total bilirubin) were analyzed upon admission.

Main Results:

  • A high frequency of abnormal LFTs was observed in 96.3% of patients.
  • Elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were noted in 96.3% and 66.7% of cases, respectively.
  • Hypoalbuminemia (42.6%) and hyperbilirubinemia (7.4%) were also detected, with higher AST, ALT, and lower albumin levels correlating significantly with disease severity.

Conclusions:

  • Hepatic dysfunction is a frequent complication in children with scrub typhus.
  • Elevated AST levels may serve as a valuable screening marker for scrub typhus in resource-limited settings.
  • Abnormalities in AST, ALT, and albumin levels are indicative of scrub typhus severity in pediatric patients.
Abstract

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