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Article: Clinical significance of hepatic derangement in severe acute respiratory syndrome
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TitleClinical significance of hepatic derangement in severe acute respiratory syndrome
 
AuthorsChan, HLY3
Kwan, ACP1
To, KF3
Lai, ST1
Chan, PKS3
Leung, WK3
Lee, N3
Wu, A3
Sung, JJY2 3
 
Issue Date2005
 
PublisherBeijing Baishideng BioMed Scientific Co., Ltd. The Journal's web site is located at http://www.wjgnet.com/1007-9327/index.htm
 
CitationWorld Journal Of Gastroenterology, 2005, v. 11 n. 14, p. 2148-2153 [How to Cite?]
 
AbstractAim: Elevation of alanine aminotransferase (ALT) level is commonly seen among patients suffering from severe acute respiratory syndrome (SARS). We report the progression and clinical significance of liver derangement in a large cohort of SARS patient. Methods: Serial assay of serum ALT was followed in patients who fulfilled the WHO criteria of SARS. Those with elevated ALT were compared with those with normal liver functions for clinical outcome. Serology for hepatitis B virus (HBV) infection was checked. Adverse outcomes were defined as oxygen desaturation, need of intensive care unit (ICU) and mechanical ventilation and death. Results: Two hundred and ninety-four patients were included in this study. Seventy (24%) patients had elevated serum ALT on admission and 204 (69%) patients had elevated ALT during the subsequent course of illness. Using peak ALT >5×ULN as a cut-off and after adjusting for potential confounding factors, the odds ratio of peak ALT >5× ULN for oxygen desaturation was 3.24 (95%CI 1.23-8.59, P = 0.018), ICU care was 3.70 (95%CI 1.38-9.89, P = 0.009), mechanical ventilation was 6.64 (95%CI 2.22-19.81, P = 0.001) and death was 7.34 (95%CI 2.28-24.89, P = 0.001). Ninety-three percent of the survived patients had ALT levels normalized or were on the improving trend during follow-up. Chronic hepatitis B was not associated with worse clinical outcomes. Conclusion: Reactive hepatitis is a common complication of SARS-coronavirus infection. Those patients with severe hepatitis had worse clinical outcome. © 2005 The WJG Press and Elsevier Inc. All rights reserved.
 
ISSN1007-9327
2013 Impact Factor: 2.433
2013 SCImago Journal Rankings: 1.022
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorChan, HLY
 
dc.contributor.authorKwan, ACP
 
dc.contributor.authorTo, KF
 
dc.contributor.authorLai, ST
 
dc.contributor.authorChan, PKS
 
dc.contributor.authorLeung, WK
 
dc.contributor.authorLee, N
 
dc.contributor.authorWu, A
 
dc.contributor.authorSung, JJY
 
dc.date.accessioned2012-09-05T05:23:58Z
 
dc.date.available2012-09-05T05:23:58Z
 
dc.date.issued2005
 
dc.description.abstractAim: Elevation of alanine aminotransferase (ALT) level is commonly seen among patients suffering from severe acute respiratory syndrome (SARS). We report the progression and clinical significance of liver derangement in a large cohort of SARS patient. Methods: Serial assay of serum ALT was followed in patients who fulfilled the WHO criteria of SARS. Those with elevated ALT were compared with those with normal liver functions for clinical outcome. Serology for hepatitis B virus (HBV) infection was checked. Adverse outcomes were defined as oxygen desaturation, need of intensive care unit (ICU) and mechanical ventilation and death. Results: Two hundred and ninety-four patients were included in this study. Seventy (24%) patients had elevated serum ALT on admission and 204 (69%) patients had elevated ALT during the subsequent course of illness. Using peak ALT >5×ULN as a cut-off and after adjusting for potential confounding factors, the odds ratio of peak ALT >5× ULN for oxygen desaturation was 3.24 (95%CI 1.23-8.59, P = 0.018), ICU care was 3.70 (95%CI 1.38-9.89, P = 0.009), mechanical ventilation was 6.64 (95%CI 2.22-19.81, P = 0.001) and death was 7.34 (95%CI 2.28-24.89, P = 0.001). Ninety-three percent of the survived patients had ALT levels normalized or were on the improving trend during follow-up. Chronic hepatitis B was not associated with worse clinical outcomes. Conclusion: Reactive hepatitis is a common complication of SARS-coronavirus infection. Those patients with severe hepatitis had worse clinical outcome. © 2005 The WJG Press and Elsevier Inc. All rights reserved.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationWorld Journal Of Gastroenterology, 2005, v. 11 n. 14, p. 2148-2153 [How to Cite?]
 
dc.identifier.epage2153
 
dc.identifier.issn1007-9327
2013 Impact Factor: 2.433
2013 SCImago Journal Rankings: 1.022
 
dc.identifier.issue14
 
dc.identifier.pmid15810082
 
dc.identifier.scopuseid_2-s2.0-17444367004
 
dc.identifier.spage2148
 
dc.identifier.urihttp://hdl.handle.net/10722/162824
 
dc.identifier.volume11
 
dc.languageeng
 
dc.publisherBeijing Baishideng BioMed Scientific Co., Ltd. The Journal's web site is located at http://www.wjgnet.com/1007-9327/index.htm
 
dc.publisher.placeChina
 
dc.relation.ispartofWorld Journal of Gastroenterology
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshAdolescent
 
dc.subject.meshAdult
 
dc.subject.meshAged
 
dc.subject.meshAged, 80 And Over
 
dc.subject.meshAlanine Transaminase - Blood
 
dc.subject.meshChild
 
dc.subject.meshFemale
 
dc.subject.meshFollow-Up Studies
 
dc.subject.meshHepatitis - Mortality - Pathology - Virology
 
dc.subject.meshHepatitis B - Complications - Mortality
 
dc.subject.meshHumans
 
dc.subject.meshLiver - Pathology - Virology
 
dc.subject.meshMale
 
dc.subject.meshMiddle Aged
 
dc.subject.meshSevere Acute Respiratory Syndrome - Complications - Mortality - Pathology
 
dc.subject.meshSeverity Of Illness Index
 
dc.titleClinical significance of hepatic derangement in severe acute respiratory syndrome
 
dc.typeArticle
 
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<contributor.author>Kwan, ACP</contributor.author>
<contributor.author>To, KF</contributor.author>
<contributor.author>Lai, ST</contributor.author>
<contributor.author>Chan, PKS</contributor.author>
<contributor.author>Leung, WK</contributor.author>
<contributor.author>Lee, N</contributor.author>
<contributor.author>Wu, A</contributor.author>
<contributor.author>Sung, JJY</contributor.author>
<date.accessioned>2012-09-05T05:23:58Z</date.accessioned>
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<description.abstract>Aim: Elevation of alanine aminotransferase (ALT) level is commonly seen among patients suffering from severe acute respiratory syndrome (SARS). We report the progression and clinical significance of liver derangement in a large cohort of SARS patient. Methods: Serial assay of serum ALT was followed in patients who fulfilled the WHO criteria of SARS. Those with elevated ALT were compared with those with normal liver functions for clinical outcome. Serology for hepatitis B virus (HBV) infection was checked. Adverse outcomes were defined as oxygen desaturation, need of intensive care unit (ICU) and mechanical ventilation and death. Results: Two hundred and ninety-four patients were included in this study. Seventy (24%) patients had elevated serum ALT on admission and 204 (69%) patients had elevated ALT during the subsequent course of illness. Using peak ALT &gt;5&#215;ULN as a cut-off and after adjusting for potential confounding factors, the odds ratio of peak ALT &gt;5&#215; ULN for oxygen desaturation was 3.24 (95%CI 1.23-8.59, P = 0.018), ICU care was 3.70 (95%CI 1.38-9.89, P = 0.009), mechanical ventilation was 6.64 (95%CI 2.22-19.81, P = 0.001) and death was 7.34 (95%CI 2.28-24.89, P = 0.001). Ninety-three percent of the survived patients had ALT levels normalized or were on the improving trend during follow-up. Chronic hepatitis B was not associated with worse clinical outcomes. Conclusion: Reactive hepatitis is a common complication of SARS-coronavirus infection. Those patients with severe hepatitis had worse clinical outcome. &#169; 2005 The WJG Press and Elsevier Inc. All rights reserved.</description.abstract>
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<subject.mesh>Adolescent</subject.mesh>
<subject.mesh>Adult</subject.mesh>
<subject.mesh>Aged</subject.mesh>
<subject.mesh>Aged, 80 And Over</subject.mesh>
<subject.mesh>Alanine Transaminase - Blood</subject.mesh>
<subject.mesh>Child</subject.mesh>
<subject.mesh>Female</subject.mesh>
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<subject.mesh>Hepatitis - Mortality - Pathology - Virology</subject.mesh>
<subject.mesh>Hepatitis B - Complications - Mortality</subject.mesh>
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Author Affiliations
  1. Princess Margaret Hospital Hong Kong
  2. Prince of Wales Hospital Hong Kong
  3. Chinese University of Hong Kong