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KMID : 0614620190740040205
Korean Journal of Gastroenterology
2019 Volume.74 No. 4 p.205 ~ p.211
Serum Aminotransferase Level in Rhabdomyolysis according to Concurrent Liver Disease
Jo Kyeong-Min

Heo Nae-Yun
Park Seung-Ha
Moon Young-Soo
Kim Tae-Oh
Park Jong-Ha
Choi Joon-Hyuk
Park Yong-Eun
Lee Jin
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.
KEYWORD
Rhabdomyolysis, Aspartate aminotransferases, Alanine transaminase, Liver diseases
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