Pediatric Gastroenterology & Nutrition institute, Ruth Children's Hospital of Haifa, Rambam Medical Center, Faculty of Medicine, Technion, Haifa, Israel.
Metabolic Clinic, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
Acta Paediatr. 2022 Mar;111(3):675-679. doi: 10.1111/apa.16123. Epub 2021 Oct 2.
Aspartate aminotransferase (AST) is an enzyme expressed in several organs; therefore, AST elevation may reflect outside of liver pathology. AST elevation may also be associated with macro-AST (m-AST). The aim of this study was to evaluate the long-term course of children with prolonged isolated AST elevation and the prevalence of m-AST in our cohort.
We retrospectively reviewed the medical charts of children diagnosed with prolonged isolated AST elevation and were evaluated for m-AST.
Thirty-two patients were included. AST elevation persisted for a median of 66.6 months and ranged from 1.23 to 12-fold upper limit of normal (ULN). Twenty-two percent were m-AST positive and 44% had borderline levels of m-AST. A statistically significant difference was found for age at presentation between the borderline and the positive m-AST groups (31 vs. 69 months, respectively. p = 0.045). None of the patients with elevated AST developed significant liver disease.
We confirm the benign course of prolonged isolated AST elevation in general and m-AST in particular. A fifth of the patients with isolated AST elevation were m-AST positive. No differences have been found in AST levels between negative, borderline or positive m-AST.
天冬氨酸氨基转移酶（AST）在多个器官中表达；因此，AST 升高可能反映了肝脏以外的病理变化。AST 升高也可能与巨 AST（m-AST）有关。本研究旨在评估长期孤立性 AST 升高患儿的长期病程，以及我们队列中 m-AST 的患病率。
我们回顾性地查阅了诊断为长期孤立性 AST 升高并评估 m-AST 的儿童的病历。
共纳入 32 例患者。AST 升高持续中位数为 66.6 个月，范围为正常上限（ULN）的 1.23 至 12 倍。22%的患者 m-AST 阳性，44%的患者 m-AST 边界值升高。边界 m-AST 和阳性 m-AST 组之间在就诊时的年龄存在统计学显著差异（分别为 31 和 69 个月，p=0.045）。无任何 AST 升高的患者出现显著的肝脏疾病。
我们证实了孤立性 AST 升高的长期病程是良性的，尤其是 m-AST。五分之一的孤立性 AST 升高患者 m-AST 阳性。在 AST 水平方面，m-AST 阴性、边界值升高或阳性患者之间无差异。
