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SEQUENTIAL CHANGES OF SERUM AMINOTRANSFERASE LEVELS IN PATIENTS WITH SEVERE ACUTE RESPIRATORY SYNDROME

Severe acute respiratory syndrome (SARS) is a newly emerging infectious disease. To describe the hepatic injury caused by this disease, we report the sequential changes of serum transaminase in probable SARS patients during a hospital outbreak in southern Taiwan. From April to June, 2003, 52 probable SARS patients were hospitalized. Serial serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were retrospectively analyzed and hepatitis B surface antigen (HBsAg) was also evaluated to correlate with the progression of this disease. Fifty-three percent of the patients had abnormal liver function during hospitalization. More than 70% of abnormal transaminase levels were mildly elevated. Most elevated levels were noted during the second week after onset of fever. Neither transaminase elevation nor HBsAg was related to the prognosis of SARS, and only advanced age was an independent predictor of poor outcome. Our study suggested that coronavirus causing SARS might induce liver damage.

Received November 24, 2003. Accepted for publication February 5, 2004.

Authors’ addresses: Keng-Liang Wu, Sheng-Nan Lu, Chi-Sin Changchien, King-Wah Chiu, Chung-Huang Kuo, Seng-Kee Chuah, and Chuan-Mo Lee, Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China. Jien-Wei Liu, Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China. Meng-Chih Lin, Division of Pulmonary and Critical Care, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China. Hock-Liew Eng, Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China. Shun-Sheng Chen, Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China. Chao-Long Chen, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China.

Reprint requests: Chuan-Mo Lee, Division of Hepato-Gastro-enterology, Department of Internal Medicine, Kaohsiug Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao Sung Hsiang 833, Kaohsiung Hsien, Taiwan, Republic of China, Telephone: 886-7-7317123 extension 8301, Fax: 886-7-7322402, E-mail: chmolee{at}ms15.hinet.net.

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