Unidad de Gastroenterología y Nutrición Pediátrica, Hospital Universitario Miguel Servet, Zaragoza, Spain.
Unidad de Gastroenterología y Nutrición Pediátrica, Hospital Universitario Miguel Servet, Zaragoza, Spain.
An Pediatr (Engl Ed). 2021 Jun;94(6):359-365. doi: 10.1016/j.anpede.2020.06.014. Epub 2021 May 20.
Although changes in liver function tests can be non-specific in numerous clinical conditions, they can be the first sign of a potentially serious disease in an asymptomatic patient.
Retrospective cohort study, performed by reviewing the records of children of a reference hospital central laboratory with alanine aminotransferase enzyme (ALT) elevation during a 6-month aleatory period.
572 blood tests with serum ALT elevation corresponding to 403 patients have been assessed during the period studied. 98 patients were excluded for presenting abnormal liver test before the study period of comorbidity that could produce ALT elevation. The remaining 305 patients, 22.6% were diagnosed with a medical condition during the first blood test that explained the ALT elevation, although only 33.3% of them were followed up until verifying their normalisation. Final study sample consists of 236 patients with abnormal liver test without apparent liver disease. Adequate follow-up was found only in 29% of them. From this group, 9 patients (13%) were diagnosed with liver disease. The rest of the samples were not properly monitored. In patients with higher serum ALT levels, follow-up was early and more appropriate.
In our area, most children without apparent liver disease are no properly monitored. Therefore, an opportunity to diagnosis and treat a potential liver disease was lost in a great number of children. All children with unexplained hypertransaminasaemia must be studied.
尽管肝功能测试的变化在许多临床情况下可能不具有特异性，但它们可能是无症状患者潜在严重疾病的第一个迹象。
回顾性队列研究，通过审查参考医院中心实验室在 6 个月随机期间丙氨酸氨基转移酶（ALT）升高的儿童记录进行。
研究期间评估了 572 次血清 ALT 升高的血液检查，对应 403 名患者。98 名患者因在研究期间存在异常肝脏检查和可能导致 ALT 升高的合并症而被排除在外。其余 305 名患者（22.6%）在第一次血液检查中被诊断出患有某种疾病，该疾病解释了 ALT 升高，尽管只有 33.3%的患者接受了随访以验证其正常化。最终的研究样本由 236 名无明显肝病的异常肝脏检查患者组成。仅在其中 29%的患者中发现了适当的随访。在这些患者中，有 9 名（13%）被诊断为肝病。其余的样本没有得到适当的监测。在血清 ALT 水平较高的患者中，随访更早且更合适。
在我们的地区，大多数没有明显肝病的儿童没有得到适当的监测。因此，许多儿童失去了诊断和治疗潜在肝病的机会。所有不明原因的高转氨酸血症患者都必须进行研究。
