The Korean Journal of Gastroenterology (대한소화기학회지)

The Korean Society of Gastroenterology (대한소화기학회)
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Serum Aminotransferase Level in Rhabdomyolysis according to Concurrent Liver Disease

횡문근융해 시 동반 간질환 유무에 따른 혈청 아미노전달효소치의 차이

  • Jo, Kyeong Min (Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine) ;
  • Heo, Nae-Yun (Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine) ;
  • Park, Seung Ha (Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine) ;
  • Moon, Young Soo (Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine) ;
  • Kim, Tae Oh (Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine) ;
  • Park, Jongha (Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine) ;
  • Choi, Joon Hyuk (Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine) ;
  • Park, Yong Eun (Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine) ;
  • Lee, Jin (Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine)
  • 조경민 (인제대학교 의과대학 인제대학교 해운대백병원 내과) ;
  • 허내윤 (인제대학교 의과대학 인제대학교 해운대백병원 내과) ;
  • 박승하 (인제대학교 의과대학 인제대학교 해운대백병원 내과) ;
  • 문영수 (인제대학교 의과대학 인제대학교 해운대백병원 내과) ;
  • 김태오 (인제대학교 의과대학 인제대학교 해운대백병원 내과) ;
  • 박종하 (인제대학교 의과대학 인제대학교 해운대백병원 내과) ;
  • 최준혁 (인제대학교 의과대학 인제대학교 해운대백병원 내과) ;
  • 박용은 (인제대학교 의과대학 인제대학교 해운대백병원 내과) ;
  • 이진 (인제대학교 의과대학 인제대학교 해운대백병원 내과)
  • Received : 2019.05.22
  • Accepted : 2019.07.08
  • Published : 2019.10.25
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Abstract

Background/Aims: The serum aminotransferase level is usually elevated in rhabdomyolysis, and these enzymes originate from the skeletal muscle. On the other hand, there is limited data showing whether the degree of elevation of these enzymes differs according to the concurrent liver disease. Methods: Patients with rhabdomyolysis were selected when their serum creatinine kinase level was >1,000 U/L. They were categorized as the group with and without concurrent liver disease. The AST and ALT levels in both groups were compared. In addition, the aminotransferase level was compared between those with rhabdomyolysis and those with alcoholic liver disease. Results: Among the 165 patients with rhabdomyolysis, 19 had concurrent liver disease. The median peak AST was higher in the group with concurrent liver disease (332 U/L [interquartile range (IQR), 127-1,604] vs. 219 U/L [IQR, 115-504]). In addition, the median peak ALT was higher in the group with concurrent liver disease (107 U/L [IQR, 74-418] vs. 101 U/L [IQR, 56-218]). On the other hand, there was no significant difference in both enzymes between the two groups. The median peak AST level was significantly higher in those with rhabdomyolysis than in those with alcoholic liver disease (221 U/L [IQR, 118-553] vs. 103 U/L [IQR, 59-206]), but the median peak ALT was not significantly different (102 U/L [IQR, 58-222] vs. 51 U/L [IQR, 26-117]). Conclusions: Rhabdomyolysis showed an elevated AST-dominant aminotransferase level, which is not different according to concurrent liver disease. Therefore, it is recommended that rhabdomyolysis be considered first in cases of elevated aminotransferase levels in patients with a suspicious skeletal muscle injury.

Keywords

Acknowledgement

The authors thank Jeong Eun Song for her hard work for data collection.

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  1. A Cross-Sectional Study of the Relationship between Serum Creatine Kinase and Liver Biochemistry in Patients with Rhabdomyolysis vol.9, pp.1, 2020, https://doi.org/10.3390/jcm9010081