BIOCHEMICAL PATTERN OF LIVER FUNCTION TESTS IN HEPATITIS E EPIDEMIC

Abstract

Objective: To evaluate the biochemical pattern of liver function tests in acute hepatitis E epidemic.
Study Design: Cross sectional descriptive study.
Place and Duration of Study: Department of Pathology Army Medical College, Rawalpindi from June ‘09 to Dec ‘09.
Patients and Methods: A total of 81 patients of acute hepatitis of all age groups, both male and female were included in the study. Patients who reported with symptoms of acute hepatitis and tested positive for hepatitis E IgM antibody were included. Detailed history, clinical examination and serial liver function tests (LFTs) were carried out. Weekly data of LFTs was arranged serially up to 4 weeks. The results were analyzed on SPSS version 17.
Results: The patients’ age ranged from 17-59 years. Serum Alanine Transaminase (ALT) values were highest in the first 2 weeks reaching 100 times the upper limit of normal (ULN). Similarly serum total bilirubin (TBil) reached up to 8 times ULN in the 1st week. The increase in serum alkaline phosphatase (ALP) was 2 times ULN and then returned to within the reference range in the 3rd and 4th weeks before other variables. Serum albumin levels remained unchanged. Prothrombin time (PT) was found to be prolonged. Two cases ended up fatally. Rest recovered fully and became symptom free.
Conclusion: Hepatitis E is a serious clinical condition. LFTs play an important role in its diagnosis. There is marked derangement of LFTs. Sharp rise in serum ALT up to 100 times ULN is a significant feature and should raise the suspicion of acute Hepatitis E.