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Serum ALT: LDH ratio in typhoid fever and acute viral hepatitis

S Balasubramanian1, K Kaarthigeyan, S Srinivas

  • 1Department of Pediatrics, Kanchi Kamakoti CHILDS Trust Hospital, 12A, Nageswara Road, Nungambakkam, Chennai 600 034, TN, India. sbsped53@sify.com

Indian Pediatrics
|August 13, 2009
PubMed

Insights

This study found that the alanine amino transferase to lactate dehydrogenase (ALT:LDH) ratio can help distinguish typhoid hepatitis from acute viral hepatitis in children. A ratio below 9 suggests typhoid, while a ratio above 9 indicates viral hepatitis.

Area of Science:

  • Pediatrics
  • Hepatology
  • Infectious Diseases

Background:

  • Typhoid fever, a common infection in children, can present with hepatitis.
  • Differentiating typhoid hepatitis from acute viral hepatitis is crucial for appropriate treatment.
  • Biochemical markers can aid in differential diagnosis.

Purpose of the Study:

  • To evaluate the utility of the serum alanine amino transferase to lactate dehydrogenase (ALT:LDH) ratio in differentiating typhoid hepatitis from acute viral hepatitis in pediatric patients.

Main Methods:

  • A comparative study was conducted on 100 children with confirmed typhoid fever.
  • Twenty-nine children with moderate hepatitis due to typhoid fever were selected.
  • Their serum ALT:LDH ratios were compared to those of 29 children with acute viral hepatitis.

Main Results:

  • The serum ALT:LDH ratio, expressed as multiples of the upper limit of normal, was consistently less than 9 in children with typhoid hepatitis.
  • In contrast, the serum ALT:LDH ratio was greater than 9 in children with acute viral hepatitis.

Conclusions:

  • The serum ALT:LDH ratio is a valuable biochemical marker for differentiating typhoid hepatitis from acute viral hepatitis in children.
  • This ratio can assist clinicians in making timely and accurate diagnoses, guiding appropriate management strategies.

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