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Clinical significance of low transaminase levels in children with inflammatory bowel disease

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Abstract

Background

Low alanine aminotransaminase (LALT) levels may be seen in patients with inflammatory bowel disease (IBD), but there has been no study about the frequency and its clinical significance. We aimed to analyze the frequency of LALT, and its clinical significance in children with IBD.

Methods

The study included the 89 patients with IBD without hepatobiliary involvement. LALT was defined as ALT levels < 5 U/L. Demographic and clinical findings and outcome of the patients with and without LALT were compared.

Results

LALT was found 47.1% of the patients. At initial examination, it was more common in female patients (92.3 vs. 41.3%, P < 0.001) and patients with CD (57.7 vs. 30.2%, P = 0.01). 75% of the patients with penetrating Crohn’s disease (CD) had LALT (P = 0.002). Hemoglobin (10.4 ± 2.1 vs. 11.7 ± 1.9 g/dL, P = 0.01), folic acid (5.2 ± 3.3 vs. 8.6 ± 5.9 ng/mL, P = 0.02) and serum albumin levels (3.6 ± 0.8 vs. 4.7 ± 5 g/dL, P = 0.002) were significantly low in patients with LALT. LALT was associted with the disease relapse within 2 weeks in 12 of the 16 patients with LALT whereas it was seen in 16 of the 73 patients without LALT during the follow-up (75 vs. 21.9%, P < 0.001). Additionally, steroid dependency was more common in patients with LALT during the follow-up (62.5 vs. 12.3%, P < 0.001).

Conclusions

LALT is common in children with IBD especially in CD and associated with low hemoglobin, albumin and folic acid levels. It may be a marker of relapse and steroid dependency.

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Funding

No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

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Authors and Affiliations

  1. Department of Pediatric Gastroenterology Hepatology and Nutrition, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey

    Murat Cakir & Elif Sag

  2. Department of Pediatric Gastroenterology Hepatology and Nutrition, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey

    Guzide Dogan & Erhun Kasirga

  3. Department of Pediatric Gastroenterology Hepatology and Nutrition, Bursa, Turkey

    Fatih Unal

Authors
  1. Murat Cakir
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  2. Elif Sag
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  3. Guzide Dogan
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  4. Fatih Unal
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  5. Erhun Kasirga
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Contributions

MC participated in the design of the study and drafted the manuscript and carried out the statistical analysis. ES participated in the design of the study and drafted the manuscript and collected the clinical data. GD collected the clinical data and helped to draft the manuscript. FU collected the clinical data and participated in the design of the study and critical revision of the article for the important content. EK collected the clinical data and participated in the design of the study and critical revision of the article for the important content. All authors had read and approved the final manuscript.

Corresponding author

Correspondence to Murat Cakir.

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Ethical approval

The study was approved by the Karadeniz Technical University, Faculty of Medicine, Scientific Research Ethic Committee, Reference Number 2018/270.

Conflict of interest

The author(s) declare that they have no competing interests.

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Cakir, M., Sag, E., Dogan, G. et al. Clinical significance of low transaminase levels in children with inflammatory bowel disease. World J Pediatr 15, 143–147 (2019). https://doi.org/10.1007/s12519-019-00235-5

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  • DOI: https://doi.org/10.1007/s12519-019-00235-5

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