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Korean J Gastroenterol  <  Volume 74(4); 2019 <  Articles

Korean J Gastroenterol 2019; 74(4): 205-211  https://doi.org/10.4166/kjg.2019.74.4.205
Serum Aminotransferase Level in Rhabdomyolysis according to Concurrent Liver Disease
Kyeong Min Jo, Nae-Yun Heo , Seung Ha Park, Young Soo Moon, Tae Oh Kim, Jongha Park, Joon Hyuk Choi, Yong Eun Park and Jin Lee
Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
Correspondence to: Nae-Yun Heo, Department of Internal Medicine, Inje University Haeundae Paik Hospital, 875 Haeun-daero, Haeundae-gu, Busan 48108, Korea. Tel: +82-51-797-0100, Fax: +82-51-797-1341, E-mail: nyheo@hanmail.net, ORCID: https://orcid.org/0000-0001-6571-8935
Received: May 22, 2019; Revised: July 4, 2019; Accepted: July 8, 2019; Published online: October 25, 2019.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
Keywords: Rhabdomyolysis; Aspartate aminotransferases; Alanine transaminase; Liver diseases


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