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Hepatic impairment induced by scrub typhus is associated with new onset of renal dysfunction.
[scrub typhus]
Scrub
typhus
is
a
potentially
fatal
infectious
disease
caused
by
Orientia
tsutsugamushi
.
There
is
little
attention
given
to
hepatic
impairment
in
the
adults
with
scrub
typhus
.
This
study
investigated
the
incidence
and
the
prognostic
implications
of
hepatic
impairment
in
patients
with
scrub
typhus
.
We
retrospectively
reviewed
a
total
of
143
adult
patients
with
scrub
typhus
who
were
admitted
between
January
1999
and
December
2010
in
Guangdong
province
,
China
.
The
patients
were
divided
into
three
groups
,
e
.
g
.
,
normal
,
mild
,
and
moderate
to
severe
groups
based
on
the
elevated
serum
ALT
and
/
or
total
bilirubin
levels
.
Furthermore
,
clinical
characteristics
and
prognosis
of
the
patient
groups
were
compared
.
109
patients
(
76
.
2
%
)
had
abnormal
liver
function
.
Among
the
patients
with
hepatic
impairment
45
cases
(
31
.
4
%
)
,
54
cases
(
37
.
8
%
)
,
and
10
cases
(
7
.
0
%
)
had
mild
,
moderate
,
and
severe
hepatic
damage
,
respectively
.
The
moderate
to
severe
hepatic
impairment
group
had
higher
levels
of
serum
creatinine
compared
with
that
of
normal
hepatic
function
.
The
incidence
of
new
onset
of
renal
dysfunction
-
defined
as
peak
serum
creatinine
>
or
=
176
micromol
/
L
during
hospital
stay
with
no
evidence
of
renal
disease
prior
hospitalization
-
was
0
%
in
the
mild
hepatic
impairment
group
,
8
.
9
%
in
the
moderate
hepatic
impairment
group
,
and
21
.
9
%
in
the
severe
hepatic
impairment
group
,
(
p
=
0
.
005
for
trend
)
.
Additionally
,
the
patients
with
hepatic
impairment
(
n
=
109
)
had
higher
incidences
of
episodes
of
thrombocytopenia
(
45
.
9
%
vs
.
8
.
82
%
,
p
<
0
.
001
)
,
hypoalbuminemia
(
50
.
5
%
vs
.
11
.
8
%
,
p
<
0
.
001
)
,
new
onset
of
renal
dysfunction
(
16
.
5
%
vs
.
0
.
0
%
,
p
=
0
.
011
)
,
and
electrocardiogram
abnormality
(
28
.
4
%
vs
.
8
.
82
%
,
p
=
0
.
019
)
than
the
patients
without
hepatic
impairment
.
The
degree
of
hepatic
impairment
induced
by
scrub
typhus
is
associated
with
new
onset
of
renal
dysfunction
.
Diseases
Validation
Diseases presenting
"total bilirubin levels"
symptom
benign recurrent intrahepatic cholestasis
scrub typhus
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