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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
American Journal of Diseases of Children – American Medical Association
Published: Aug 1, 1988
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