Document Detail

Transient hypertransaminasemia in paediatric patients with Crohn disease undergoing initial treatment with enteral nutrition.
MedLine Citation:
PMID:  20601906     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Total enteral nutrition (TEN) is frequently used as monotherapy in children with Crohn disease to prevent steroid toxicity. Liver disease is a known complication in inflammatory bowel disease, and liver enzymes are regularly obtained in these patients.
PATIENTS AND METHODS: Prospective follow-up of liver enzymes was performed in 11 new consecutive patients ages 7.6 to 17.1 years who were primarily treated with TEN for 6 weeks. Liver enzymes were measured before starting TEN and after 3, 6, and 12 weeks.
RESULTS: At the beginning of TEN, the mean aspartate aminotransferase (ASAT) was 18.4 U/L and the mean alanine aminotransferase (ALAT) 17.1 U/L. The mean ASAT and ALAT were 202.0 U/L and 269.0 U/L after 3 weeks and 109.6 U/L and 180.9 U/L at 6 weeks. After 12 weeks values decreased to 22.8 U/L (ASAT) and 20.9 U/L (ALAT). Overall, 9 of 11 patients had transient elevated ASAT and 10 patients showed elevated ALAT. Gamma-glutamyl transpeptidase was slightly elevated in 3 patients during therapy, but alkaline phosphatase and bilirubin showed no changes. None of the patients developed liver disease during follow-up, and prolonged clinical remission was achieved in 9 patients.
CONCLUSIONS: This study shows that TEN can be associated with transient hypertransaminasemia without evidence of liver disease. We hypothesise that insulin resistance in patients with Crohn disease in combination with standard TEN formulae can result in transient hepatic steatosis causing the hypertransaminasemia. For the clinician it is important to be aware of this benign TEN-associated condition to prevent unnecessary investigations.
Ellen Schatorjé; Hans Hoekstra
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  51     ISSN:  1536-4801     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-02     Completed Date:  2011-03-03     Revised Date:  2011-09-08    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  336-40     Citation Subset:  IM    
Department of Pediatrics, Hieronymus Bosch Hospital, Hertogenbosch, The Netherlands.
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MeSH Terms
Alanine Transaminase / blood*
Aspartate Aminotransferases / blood*
Crohn Disease / blood*,  complications,  therapy
Enteral Nutrition*
Liver Diseases / etiology
Remission Induction
gamma-Glutamyltransferase / blood
Reg. No./Substance:
EC; EC Aminotransferases; EC Transaminase
Comment In:
J Pediatr Gastroenterol Nutr. 2011 Aug;53(2):229   [PMID:  21788771 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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