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Hepatitis in Acquired Rubella Infection in Children

Hepatitis in Acquired Rubella Infection in Children Abstract Sir.—Although congenital rubella frequently is accompanied by hepatocellular disease,1 liver involvement in acute acquired rubella, to our knowledge, has not been recognized.2,3 Recently, Zeldis et al4 reported a case of rubella accompanied by serum aminotransferase level elevations in an adult. We determined liver-derived serum enzyme levels in pediatric patients with rubella to clarify the incidence and clinical features of liver involvement. Early in 1987, a rubella epidemic occurred in Japan. In this study, we analyzed 241 patients who were serologically confirmed to have rubella by a hemagglutination inhibition test. At the first visit, we measured serum bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and its isoenzymes, alkaline phosphatase (AP), and γ-glutamyltransferase (GGT) levels. We arbitrarily defined liver dysfunction as an elevation of ALT level over 100 U/L. Normal reference interval levels are AST, 20 to 50 U/L; ALT, 10 to 40 U/L; and LDH, References 1. Esterly JR, Slusser RJ, Ruebner BH: Hepatic lesions in the congenital rubella syndrome . J Pediatr 1967;71:676-685.Crossref 2. Schiff GM: Hepatitis caused by viruses other than hepatitis A, hepatitis B, and non-A non-B hepatitis viruses , in Schiff L, Schiff ER (eds): Diseases of the Liver , ed 5. Philadelphia, JB Lippincott, 1982, pp 611-620. 3. Sherlock S: Diseases of the Liver and Biliary System , ed 6. Boston, Blackwell Scientific Publications Inc, 1981, pp 266-269. 4. Zeldis JB, Miller JG, DienstagJL: Hepatitis in an adult with rubella . Am J Med 1985;79:515-516.Crossref 5. Krugman S, Katz SL: Infectious Diseases of Children . St Louis, CV Mosby Co, 1981, pp 315-331. 6. Bayer WL, Sherman FE, Michaels RH, et al: Purpura in congenital and acquired rubella . N Engl J Med 1965;273:1362-1366, 1390-1391.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1988.02150080023012
Publisher site
See Article on Publisher Site

Abstract

Abstract Sir.—Although congenital rubella frequently is accompanied by hepatocellular disease,1 liver involvement in acute acquired rubella, to our knowledge, has not been recognized.2,3 Recently, Zeldis et al4 reported a case of rubella accompanied by serum aminotransferase level elevations in an adult. We determined liver-derived serum enzyme levels in pediatric patients with rubella to clarify the incidence and clinical features of liver involvement. Early in 1987, a rubella epidemic occurred in Japan. In this study, we analyzed 241 patients who were serologically confirmed to have rubella by a hemagglutination inhibition test. At the first visit, we measured serum bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and its isoenzymes, alkaline phosphatase (AP), and γ-glutamyltransferase (GGT) levels. We arbitrarily defined liver dysfunction as an elevation of ALT level over 100 U/L. Normal reference interval levels are AST, 20 to 50 U/L; ALT, 10 to 40 U/L; and LDH, References 1. Esterly JR, Slusser RJ, Ruebner BH: Hepatic lesions in the congenital rubella syndrome . J Pediatr 1967;71:676-685.Crossref 2. Schiff GM: Hepatitis caused by viruses other than hepatitis A, hepatitis B, and non-A non-B hepatitis viruses , in Schiff L, Schiff ER (eds): Diseases of the Liver , ed 5. Philadelphia, JB Lippincott, 1982, pp 611-620. 3. Sherlock S: Diseases of the Liver and Biliary System , ed 6. Boston, Blackwell Scientific Publications Inc, 1981, pp 266-269. 4. Zeldis JB, Miller JG, DienstagJL: Hepatitis in an adult with rubella . Am J Med 1985;79:515-516.Crossref 5. Krugman S, Katz SL: Infectious Diseases of Children . St Louis, CV Mosby Co, 1981, pp 315-331. 6. Bayer WL, Sherman FE, Michaels RH, et al: Purpura in congenital and acquired rubella . N Engl J Med 1965;273:1362-1366, 1390-1391.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Aug 1, 1988

References