Korean J Med.
2000 Feb;58(2):189-196.
Clinical usefulness of serum isocitrate dehydrognase as a marker of
centrilobular hepatic necrosis in patients with hyperthyroidism
- Affiliations
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- 1Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul.
- 2Dankook University College of Medicine, Chunan, Korea.
Abstract
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BACKGROUND: The zonal differentiation of hepatic necrosis is important in the aspect
of treatment, follow-up and prognosis of patients. The purpose of this study was
evaluating the clinical usefulness of serum isocitrate dehydrogenase (ICDH) as
a marker of centrilobular hepatic necrosis in patients with hyperthyroidism.
METHODS
We determined the serum ICDH and alanine aminotransferase (ALT) activities
in 56 patients with hyperthyroidism, 16 patients with chronic viral hepatitis, and
17 normal controls.
RESULTS
The activities of serum ICDH were significantly higher in patients with
hyperthyroidism than those of patients with chronic viral hepatitis or normal
control (p< 0.01), even though those of serum ALT were higher in patients
with chronic viral hepatitis (p< 0.01). The ratio of serum ICDH and ALT
activities were markedly different between the patients with hyperthyroidism
and chronic viral hepatitis (p< 0.001). There was a significant correlation
between the serum ICDH and ALT activities in patients with hyperthyroidism as
well as in those with chronic viral hepatitis (p< 0.05). In patients with
hyperthyroidism, the serum ICDH levels were more significantly correlated with
serum triiodothyronine (T3) than thyroxine (T4) levels. In a patients with
hyperthyroidism and elevated ALT levels, the serum ICDH activity decreased
progressively and was normalized ultimately, as serum ALT level and thyroid
function were normalized with antithyroid medication.
CONCLUSION
The serum ICDH or ratio of serum ICDH and ALT activities might
be useful clinically in differentiating the centrilobular from periportal
hepatic necrosis, and following up the degree of hepatic necrosis in patients
with hyperthyroidism.