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Extent of measles hepatitis in various ages
H Shalev-Zimels1, Z Weizman, C Lotan
1Division of Pediatrics, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Abstract:
To assess extent of hepatic involvement in measles, we evaluated prospectively 144 patients (ages 0.2 to 43 years) during an outbreak. Liver function parameters (AST, ALT, serum gamma-glutamyl transpeptidase and bilirubin) were determined on presentation and at 2 and 4 weeks. The study comprised 52 pediatric (less than or equal to 14 years) and 92 adult patients. Liver dysfunction was evident quite often (56 to 66%) in adult patients. However, in the pediatric age group, these abnormalities were less frequent and less extensive. Moreover, a significant correlation was noted between age and each of the following parameters: AST (r = 0.61), ALT (r = 0.56) and serum gamma-glutamyl transpeptidase (r = 0.39). In all subjects all parameters normalized after 2 to 4 weeks. The data presented suggest that hepatic dysfunction in measles is probably not rare and is more frequent and more extensive in adults. However, these abnormalities seem to be subclinical, self-limited and probably with no long-term sequelae.
Insights
Measles can cause liver dysfunction, particularly in adults, though it is usually mild and temporary. This study found liver abnormalities in adults more often than in children, with all cases resolving within weeks.
Area of Science:
- Hepatology
- Infectious Diseases
- Pediatrics
Background:
- Measles (Morbillivirus) is a highly contagious viral illness.
- Hepatic involvement in measles is not well-characterized, especially regarding age-related differences.
- Understanding liver function during measles is crucial for comprehensive patient management.
Purpose of the Study:
- To prospectively evaluate the extent and frequency of hepatic involvement in patients with measles.
- To compare liver function abnormalities between pediatric and adult measles cases.
- To determine the correlation between patient age and liver function parameters during measles.
Main Methods:
- Prospective evaluation of 144 measles patients (52 pediatric, 92 adult) during an outbreak.
- Measurement of liver function parameters: aspartate aminotransferase (AST), alanine aminotransferase (ALT), serum gamma-glutamyl transpeptidase, and bilirubin.
- Repeated assessments at presentation, 2 weeks, and 4 weeks post-presentation.
Main Results:
- Liver dysfunction was observed in 56-66% of adult patients, compared to less frequent and extensive abnormalities in pediatric patients.
- Significant positive correlations were found between patient age and AST (r=0.61), ALT (r=0.56), and serum gamma-glutamyl transpeptidase (r=0.39).
- All measured liver function parameters normalized within 2 to 4 weeks in all subjects.
Conclusions:
- Hepatic dysfunction is a common, albeit often subclinical, complication of measles.
- Adults experience more frequent and extensive liver involvement than children during measles.
- Measles-associated hepatic abnormalities are self-limited and unlikely to cause long-term sequelae.