Liver Function Test Abnormalities in Scrub Typhus

Dr. MVS.Subbalaxmi; Dr. Kesari Raja Mohan Reddy; Dr. K.Krishna Prasad; Dr. V.Laxmi

Volume : VIII, Issue : III, March - 2019

Liver Function Test Abnormalities in Scrub Typhus

Dr. Mvs. Subbalaxmi, Dr. Kesari Raja Mohan Reddy, Dr. K. Krishna Prasad, Dr. V. Laxmi

Abstract :

Introduction: Scrub typhus is a rickettsial disease caused by Orientia tsutsugamushi. It is an important re–emerging infection in most parts of India. It had wide spectrum of presentation involving various systems of the body. The most common laboratory abnormality is alteration in the liver function tests. Presence of rural background and varied manifestations and abnormalities in LFT can support suspicion towards the diagnosis of scrub typhus. Methods: Diagnosis of scrub typhus was confirmed by weil felix test, immunochromatographic test and/or IgM ELISA. Clinical features and liver function tests were analysed. Results: Total of 71 patients were diagnosed in 1 year duration and their liver function tests (LFT) were analysed. Hepatic enzyme derangement is the most common laboratory abnormality in this study. Fifty nine of 71(83.1%) had some degree of hepatic enzyme derangement. Mild aspartate aminotransferase (AST) elevation was seen in 22 patients (40–80 u), moderate elevation (80–120) in 18 patients and >3 times elevation was seen in 20 patients. Alanine aminotransferase (ALT) elevation was seen in 59 patients, 1–2 times in 26 patients, 2–3 times in 20 patients, and >3 times in 13 patients. Serum alkaline phosphatase (ALP) elevation was seen in 45 patients,1–2 times in 32 patients, 2–3 times in 4 patients, and >3 times in 9 patients. ALP elevation is one of the characteristic findings of scrub typhus due to cholestatic hepatopathy like in other sepsis. Bilirubin elevation was seen in 41 patients, >3 times seen in 12 patients. Most of patients had conjugate hyperbilirubinemia. Hypoalbuminemia was seen in 64 patients, among them severe hypoalbuminemia (<2.5) was seen in 34 patients. One observation in our study was 90% patients had hypoalbuminemia and 50% had severe hypoalbuminemia. None had received albumin transfusion. Conclusion: Liver function abnormalities are most common among various laboratory abnormalities. Elevation of transaminases and alkaline phosphatase are in favour of scrub typhus in suspicious cases.