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Elevated Values of Clinically Relevant Transferases Induced by Imported Infectious Diseases: A Controlled Cross-Sectional Study of 14,559 Diseased German Travelers Returning from the Tropics and Subtropics.
Am J Trop Med Hyg. 2016 08 03; 95(2):481-7.AJ

Abstract

The aim of this controlled cross-sectional study was to assess the clinical validity of elevated values of three clinically relevant transferase enzymes (aspartate transaminase [AST], alanine transaminase [ALT], and gamma-glutamyl transferase [GGT]) induced by imported infectious diseases (IDs) seen among patients consulting the Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (from 1999 to 2014) after being in the sub-/tropics. Data sets of 14,559 diseased German travelers returning from Latin America (2,715), Africa (4,574), or Asia (7,270) and of 1,536 healthy controls of German origin without recent travels were analyzed. Among the cases, the proportions of those with elevated values of AST (7.8%) and of ALT (13.4%) were significantly larger than among controls (4.0% and 10.6%, respectively), whereas for GGT, no significant difference was found (cases: 10.0%; controls: 11.4%). The study identified IDs with significantly larger proportions of both AST and ALT (hepatitis A [100%/100%], cytomegalovirus [CMV] infection [77%/81%], chronic hepatitis C [67%/67%], infectious mononucleosis [65%/77%], typhoid fever [50%/50%], cyclosporiasis [45%/66%], dengue fever [43%/35%], malaria [20%/27%], and rickettsiosis [20%/24%]), of AST alone (paratyphoid fever [42%]), of ALT alone (giardiasis [20%]), and of GGT (hepatitis A [100%], infectious mononucleosis [71%], CMV infection [58%], rickettsiosis (20%], and dengue fever [19%]). The study demonstrates that the determination of AST and ALT among travelers returning from the sub-/tropics has a high clinical validity, as their elevated values are typically caused by several imported viral, bacterial, and protozoan IDs, whereas no additional clinical validity was found by the determination of GGT.

Authors+Show Affiliations

Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany. herbinger@lrz.uni-muenchen.de.Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany.Department of Anesthesiology, Critical Care and Pain Medicine, Neuperlach Medical Center, Munich, Germany.Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany.Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany.Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany.Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany.Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany.Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany.Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany. German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany.Division of Infectious Diseases and Tropical Medicine (DITM), Medical Center of the University of Munich, Munich, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27215300

Citation

Herbinger, Karl-Heinz, et al. "Elevated Values of Clinically Relevant Transferases Induced By Imported Infectious Diseases: a Controlled Cross-Sectional Study of 14,559 Diseased German Travelers Returning From the Tropics and Subtropics." The American Journal of Tropical Medicine and Hygiene, vol. 95, no. 2, 2016, pp. 481-7.
Herbinger KH, Hanus I, Felbinger TW, et al. Elevated Values of Clinically Relevant Transferases Induced by Imported Infectious Diseases: A Controlled Cross-Sectional Study of 14,559 Diseased German Travelers Returning from the Tropics and Subtropics. Am J Trop Med Hyg. 2016;95(2):481-7.
Herbinger, K. H., Hanus, I., Felbinger, T. W., Weber, C., Beissner, M., von Sonnenburg, F., Löscher, T., Bretzel, G., Nothdurft, H. D., Hoelscher, M., & Alberer, M. (2016). Elevated Values of Clinically Relevant Transferases Induced by Imported Infectious Diseases: A Controlled Cross-Sectional Study of 14,559 Diseased German Travelers Returning from the Tropics and Subtropics. The American Journal of Tropical Medicine and Hygiene, 95(2), 481-7. https://doi.org/10.4269/ajtmh.16-0224
Herbinger KH, et al. Elevated Values of Clinically Relevant Transferases Induced By Imported Infectious Diseases: a Controlled Cross-Sectional Study of 14,559 Diseased German Travelers Returning From the Tropics and Subtropics. Am J Trop Med Hyg. 2016 08 3;95(2):481-7. PubMed PMID: 27215300.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Elevated Values of Clinically Relevant Transferases Induced by Imported Infectious Diseases: A Controlled Cross-Sectional Study of 14,559 Diseased German Travelers Returning from the Tropics and Subtropics. AU - Herbinger,Karl-Heinz, AU - Hanus,Ingrid, AU - Felbinger,Thomas W, AU - Weber,Christine, AU - Beissner,Marcus, AU - von Sonnenburg,Frank, AU - Löscher,Thomas, AU - Bretzel,Gisela, AU - Nothdurft,Hans Dieter, AU - Hoelscher,Michael, AU - Alberer,Martin, Y1 - 2016/05/23/ PY - 2016/03/21/received PY - 2016/04/16/accepted PY - 2016/5/25/entrez PY - 2016/5/25/pubmed PY - 2017/5/23/medline SP - 481 EP - 7 JF - The American journal of tropical medicine and hygiene JO - Am J Trop Med Hyg VL - 95 IS - 2 N2 - The aim of this controlled cross-sectional study was to assess the clinical validity of elevated values of three clinically relevant transferase enzymes (aspartate transaminase [AST], alanine transaminase [ALT], and gamma-glutamyl transferase [GGT]) induced by imported infectious diseases (IDs) seen among patients consulting the Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (from 1999 to 2014) after being in the sub-/tropics. Data sets of 14,559 diseased German travelers returning from Latin America (2,715), Africa (4,574), or Asia (7,270) and of 1,536 healthy controls of German origin without recent travels were analyzed. Among the cases, the proportions of those with elevated values of AST (7.8%) and of ALT (13.4%) were significantly larger than among controls (4.0% and 10.6%, respectively), whereas for GGT, no significant difference was found (cases: 10.0%; controls: 11.4%). The study identified IDs with significantly larger proportions of both AST and ALT (hepatitis A [100%/100%], cytomegalovirus [CMV] infection [77%/81%], chronic hepatitis C [67%/67%], infectious mononucleosis [65%/77%], typhoid fever [50%/50%], cyclosporiasis [45%/66%], dengue fever [43%/35%], malaria [20%/27%], and rickettsiosis [20%/24%]), of AST alone (paratyphoid fever [42%]), of ALT alone (giardiasis [20%]), and of GGT (hepatitis A [100%], infectious mononucleosis [71%], CMV infection [58%], rickettsiosis (20%], and dengue fever [19%]). The study demonstrates that the determination of AST and ALT among travelers returning from the sub-/tropics has a high clinical validity, as their elevated values are typically caused by several imported viral, bacterial, and protozoan IDs, whereas no additional clinical validity was found by the determination of GGT. SN - 1476-1645 UR - https://www.unboundmedicine.com/medline/citation/27215300/Elevated_Values_of_Clinically_Relevant_Transferases_Induced_by_Imported_Infectious_Diseases:_A_Controlled_Cross_Sectional_Study_of_14559_Diseased_German_Travelers_Returning_from_the_Tropics_and_Subtropics_ L2 - https://ajtmh.org/doi/10.4269/ajtmh.16-0224 DB - PRIME DP - Unbound Medicine ER -