PEDIATRICS Vol. 58 No. 5 November 1976, pp. 730-736
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Serum Enzyme Abnormalities in Juvenile Rheumatoid Arthritis

Gary S. Rachelefsky M.D.1, Nirmal C. Kar Ph.D.1, Anne Coulson M.A.1, Edmund Sarkissian 1, E. Richard Stiehm M.D.1, and Harold E. Paulus M.D.1

1 Departments of Pediatrics Medicine, and Epidemiology, School of Medicine, University of California, Los Angeles

Elevated serum transaminases, particularly SGOT, as a result of acetylsalicylic acid (ASA) therapy have been reported in patients with juvenile rheumatoid arthritis (JRA). In order to evaluate the possibilities that these elevated transaminases may result from JRA itself or from concomitant muscle injury, we correlated liver function tests and a specific test for muscle damage, creatine phosphokinase (CPK), with ASA therapy in 37 patients. These JRA patients were evaluated serially; 20 took ASA continuously, 6 took it intermittently, and 11 were on no therapy. Thirty-five healthy children were also studied to establish normal control values for the serum enzyme tests.

Mean SGOT and SGPT in the 11 untreated subjects were significantly (P < .001) higher than normal controls while CPK and alkaline phosphatase (AP) were not elevated. Mean SGOT and SGPT were also significantly (P < .001) elevated in 20 children receiving ASA continuously; CPK was normal and AP less (P < .05) than normal. CPK was elevated in 13 patients. Elevation of enzymes was sporadic and there was no correlation with serum salicylate, sex, age, disease duration, type, or activity.

We conclude that mild abnormalities of SGOT and SGPT in JRA patients are common, but that they occur sporadically and elevated values appear to be unrelated to ASA therapy.

Submitted on October 10, 1975
Accepted on February 13, 1976




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[Abstract] [PDF]