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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
"respectively"
symptom
adrenal incidentaloma
allergic bronchopulmonary aspergillosis
alpha-thalassemia
benign recurrent intrahepatic cholestasis
carcinoma of the gallbladder
congenital adrenal hyperplasia
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
cystinuria
dedifferentiated liposarcoma
dentin dysplasia
dentinogenesis imperfecta
epidermolysis bullosa simplex
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
harlequin ichthyosis
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
kallmann syndrome
lamellar ichthyosis
liposarcoma
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyruvate dehydrogenase deficiency
scrub typhus
triple a syndrome
von hippel-lindau disease
well-differentiated liposarcoma
wolf-hirschhorn syndrome
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