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Serum Liver Enzyme Pattern in Birth Asphyxia Associated Liver Injury

PURPOSE: To study temporal pattern of serum liver enzymes levels in newborns with hepatic injury associated with birth asphyxia (BA). METHODS: Singleton term newborns with BA and ≤72 hours of age admitted to neonatal intensive care unit were prospectively enrolled. Term newborns with physiological j...

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Autores principales: Chhavi, Nanda, Zutshi, Kiran, Singh, Niranjan Kumar, Awasthi, Ashish, Goel, Amit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209321/
https://www.ncbi.nlm.nih.gov/pubmed/25349832
http://dx.doi.org/10.5223/pghn.2014.17.3.162
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author Chhavi, Nanda
Zutshi, Kiran
Singh, Niranjan Kumar
Awasthi, Ashish
Goel, Amit
author_facet Chhavi, Nanda
Zutshi, Kiran
Singh, Niranjan Kumar
Awasthi, Ashish
Goel, Amit
author_sort Chhavi, Nanda
collection PubMed
description PURPOSE: To study temporal pattern of serum liver enzymes levels in newborns with hepatic injury associated with birth asphyxia (BA). METHODS: Singleton term newborns with BA and ≤72 hours of age admitted to neonatal intensive care unit were prospectively enrolled. Term newborns with physiological jaundice and without BA were studied as controls. Serum liver enzymes were measured at <24 hours, 24-72 hours, and at 6-12 days of age for cases and at 1-6 days of age for controls. BA was defined by 1 minute Apgar score <7 or delayed or absent cry with hypoxic ischemic encephalopathy. BA-associated liver injury was defined as serum alanine aminotransferase (ALT) elevation beyond +2 standard deviation (ALT > +2 SD) above the mean of control subjects at any of the three time points. RESULTS: Sixty controls and 62 cases were enrolled. Thirty-five cases (56%) developed BA-associated liver injury (ALT>81 IU/L). They had higher serum levels of ALT, aspartate aminotransferase, lactate dehydrogenase than the control infants, with peak at 24-72 hours. In controls, serum liver enzyme levels were significantly higher in appropriate-for-date (AFD) babies than small-for-date (SFD) babies. Serum enzyme pattern and extent of elevation were comparable between SFD and AFD babies. Degree of serum liver enzyme elevation had no relationship with severity of hypoxic encephalopathy. CONCLUSION: Serum liver enzyme elevation is common in BA; it peaks at 24-72 hours followed by a sharp decline by 6-12 days of age. Pattern and extent of enzyme elevation are comparable between SFD and AFD babies.
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spelling pubmed-42093212014-10-27 Serum Liver Enzyme Pattern in Birth Asphyxia Associated Liver Injury Chhavi, Nanda Zutshi, Kiran Singh, Niranjan Kumar Awasthi, Ashish Goel, Amit Pediatr Gastroenterol Hepatol Nutr Original Article PURPOSE: To study temporal pattern of serum liver enzymes levels in newborns with hepatic injury associated with birth asphyxia (BA). METHODS: Singleton term newborns with BA and ≤72 hours of age admitted to neonatal intensive care unit were prospectively enrolled. Term newborns with physiological jaundice and without BA were studied as controls. Serum liver enzymes were measured at <24 hours, 24-72 hours, and at 6-12 days of age for cases and at 1-6 days of age for controls. BA was defined by 1 minute Apgar score <7 or delayed or absent cry with hypoxic ischemic encephalopathy. BA-associated liver injury was defined as serum alanine aminotransferase (ALT) elevation beyond +2 standard deviation (ALT > +2 SD) above the mean of control subjects at any of the three time points. RESULTS: Sixty controls and 62 cases were enrolled. Thirty-five cases (56%) developed BA-associated liver injury (ALT>81 IU/L). They had higher serum levels of ALT, aspartate aminotransferase, lactate dehydrogenase than the control infants, with peak at 24-72 hours. In controls, serum liver enzyme levels were significantly higher in appropriate-for-date (AFD) babies than small-for-date (SFD) babies. Serum enzyme pattern and extent of elevation were comparable between SFD and AFD babies. Degree of serum liver enzyme elevation had no relationship with severity of hypoxic encephalopathy. CONCLUSION: Serum liver enzyme elevation is common in BA; it peaks at 24-72 hours followed by a sharp decline by 6-12 days of age. Pattern and extent of enzyme elevation are comparable between SFD and AFD babies. The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition 2014-09 2014-09-30 /pmc/articles/PMC4209321/ /pubmed/25349832 http://dx.doi.org/10.5223/pghn.2014.17.3.162 Text en Copyright © 2014 by The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Chhavi, Nanda
Zutshi, Kiran
Singh, Niranjan Kumar
Awasthi, Ashish
Goel, Amit
Serum Liver Enzyme Pattern in Birth Asphyxia Associated Liver Injury
title Serum Liver Enzyme Pattern in Birth Asphyxia Associated Liver Injury
title_full Serum Liver Enzyme Pattern in Birth Asphyxia Associated Liver Injury
title_fullStr Serum Liver Enzyme Pattern in Birth Asphyxia Associated Liver Injury
title_full_unstemmed Serum Liver Enzyme Pattern in Birth Asphyxia Associated Liver Injury
title_short Serum Liver Enzyme Pattern in Birth Asphyxia Associated Liver Injury
title_sort serum liver enzyme pattern in birth asphyxia associated liver injury
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209321/
https://www.ncbi.nlm.nih.gov/pubmed/25349832
http://dx.doi.org/10.5223/pghn.2014.17.3.162
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