Relation of transaminase levels with severity of Hepatitis A in children.

Rehan Mehmood; Farooq Ikram; Babar Ali; Sammara Sarwar; Zohaib Akhtar; Bilal Munawar

doi:10.51253/pafmj.v75iSUPPL-4.10330

Authors

Rehan Mehmood Department of Pediatrics, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Farooq Ikram Department of Pediatrics, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Babar Ali Department of Pediatrics, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Sammara Sarwar Department of General Medicine, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Zohaib Akhtar Department of Pediatrics, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Bilal Munawar Department of Pediatrics, Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75iSUPPL-4.10330

Keywords:

Alanine Transaminase, Aspartate Transaminase, Diagnostic Accuracy, Severe Hepatitis A.

Abstract

Objectives: To determine the sensitivity, specificity and diagnostic accuracy of serum alanine transaminase and serum aspartate transaminase in detecting the presence of severe Hepatitis A in children.

Study Design: Cross-sectional validation study.

Place and Duration of Study: Department of Pediatrics, Combined Military Hospital, Rawalpindi Pakistan, Jan to Sep 2022.

Methodology: This study was conducted on 201 patients diagnosed with acute hepatitis A. All patients underwent testing for serum ALT, AST and LDH levels as well for PT/INR. Patients were labelled as suffering from severe hepatitis if INR was greater than 1.5. A 2x2 table was constructed to calculate the sensitivity, specificity and diagnostic accuracy for serum ALT, AST, ALT/AST ratio and ALT/LDH ratio in detecting the presence of severe hepatitis.

Results: The mean age of the sample at the time of the study was 7.47±2.54 years, while 103(51.2%) were female. Serum ALT levels showed a sensitivity of 81.6% and a specificity of 36.0%. Serum AST had a sensitivity and specificity of 86.2% and 27.2% for the same, while the ALT/LDH ratio and the AST/LDH ratio had a sensitivity and specificity of 88.5% and 39.5%, and 100% and 1.7%, respectively for the detection of presence of severe Hepatitis A. Lastly, the ALT/AST ratio had 0% sensitivity and 100% specificity for the detection of severe hepatitis A.

Conclusion: Liver enzyme levels and various associated ratios have low sensitivity and specificity for the detection acute severe hepatitis A.

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