Serum transaminase variations in childhood.

The study of serum transaminases has recently entered clinical practice. In December, 1954, Wroblewsky and La Due demonstrated an increase of glutamic-oxalacetic (GOT) transaminase in the serum of patients suffering from various liver diseases and in carbon tetrachloride intoxication. In 1955, de Ritis, Coltorti and Giusti demonstrated an increase of both aspartic-ketoglutaric (GOT) and alanine-ketoglutaric (GPT) transaminases in the serum of patients with infectious hepatitis. This increase was accompanied by a remarkable inversion of the ratio between aspartic-ketoglutaric (GOT) and alanine-ketoglutaric activity (GPT), (GOT ~GP'T' which stands above unity in healthy people and notably below in infectious hepatitis. While the increase of serum transaminase is generally ascribed to extensive necrosis of the hepatic cells and the consequent passage into the blood of cellular enzymes, the inversion of the ratio has not yet been satisfactorily explained. A series of clinical and experimental observations made during the last two years has enabled us to reach some interesting conclusions. Our clinical researches concerned about 100 cases of acute infectious diseases, including infectious hepatitis, rheumatic fever, measles, scarlet fever, whooping cough, chickenpox, infectious mononucleosis, mumps and poliomyelitis. In some of the abovementioned diseases multiplication of the causal agent in the liver during the incubation stage takes place, and liver damage is frequently observed at needle-biopsy. In estimating the serum transaminases we used the method of Tonhazy, White and Umbreit (1950) reading with Pulfrich's photometer, filter S 53. The results are set out in Figs. 1, 2 and 3, the values being expressed in micromoles of pyruvic acid. These figures show that only in infectious hepatitis, from virus A or B, is there a definite increase of both transaminases accompanied by the characteristic inversion of the ratio. This specific finding is probably related to the extensive liver 409 E 0 0