National Journal of Community Medicine (May 2016)
Study Of Serum Alanine Transaminase: Serum Lactate Dehydrogenase Ratio for Typhoid Hepatitis
Abstract
Introduction: Typhoid hepatitis clinically mimics acute viral hepatitis. Differentiation between these two illnesses is very important as typhoid hepatitis requires definitive treatment in form of antimicrobial drugs. This study was undertaken to study pattern of hepatic involvement in enteric fever and to evaluate serum ALT:LDH ratio for differentiating it from acute viral hepatitis. Material and Method :This was a clinical observational study .Patients of enteric fever with hepatic manifestations were investigated with special reference to liver function tests, serum LDH and serum S ALT: S. LDH ratio. Results of these were compared with investigations of confirmed cases of viral hepatitis. Result: Values of S.ALT, S.LDH and S.ALT:S.LDH were 121-1170 (mean 293±266), 150-2150 (mean 677±543) and 0.07-3.5 (0.52±0.5) respectively in enteric hepatitis, while in viral hepatitis were 580-2280 (1320±293), 290-1180 (445±180) and 4.5-87.2 (40±15) respectively. There is much more alteration of S.ALT level in patient of viral hepatitis as compared to typhoid hepatitis (p<0.05) and levels of LDH are more raised in patients of typhoid hepatitis as compared to viral hepatitis (p <0.05).So,the values of S.ALT:LDH ratio are higher in acute viral hepatitis as compared to enteric hepatitis (p<0.05). Conclusion: S.ALT:S.LDH ratio´s cut off value of 4 can be used to differentiate between viral and Typhoid hepatitis.
