Gammaglutamyl transpeptidase activity in patients with schistosomiasis

Schistosoma mansoni infestation may induce liver fibrosis and portal hypertension, with possible elevation of liver enzymes.

The aim of this study was to evaluate the serum gammaglutamyl transpeptidase (GGT) activity in a group of non-alcoholic and non-obese patients with hepatointestinal schistosomiasis.

Medical records of 174 patients diagnosed to have hepatointestinal schistosomiasis on the basis of clinical and laboratory data were reviewed. Body mass index (BMI) was calculated for all patients. Direct stool smear and formol-ether concentration (FEC) methods and hematological and biochemical blood tests were performed. Other studies including abdominal ultrasonography, upper and lower gastrointestinal endoscopy was also performed when feasible. All (174) patients were adults with male to female ratio of 3.8:1. BMI was similar in both groups. Patients were divided into two groups: group 1 (57) with elevated GGT and group 2 (117) patients with normal GGT. Both groups had positive indirect hemagglutination test (IHA) for schistosomiasis. Other causes of liver disease were excluded.

Group 1 had significant elevation of alanine aminotransferase (ALT), alkaline phosphatase (ALP) and reduction in platelets (p < 0.001), low albumin and high globulin levels (p < 0.01) compared to group 2. Abnormal ultrasonographic findings were more frequently encountered in group 1 (p < 0.001).

The above data indicated that GGT elevation was most likely secondary to hepatobiliary involvement by Schistosoma mansoni and may indicate chronicity. Therefore schistosomiasis has to be considered in our community whenever GGT is elevated in non-alcoholic population.