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Serum Aminotransferase Level in Rhabdomyolysis according to Concurrent Liver Disease

대한소화기학회지 2019년 74권 4호 p.205 ~ 211
조경민 ( Jo Kyeong-Min ) - 인제대학교 의과대학 해운대백병원 내과

허내윤 ( Heo Nae-Yun ) - 인제대학교 의과대학 인제대학교 해운대백병원 내과
박승하 ( Park Seung-Ha ) - 인제대학교 의과대학 인제대학교 해운대백병원 내과
문영수 ( Moon Young-Soo ) - 인제대학교 의과대학 인제대학교 해운대백병원 내과
김태오 ( Kim Tae-Oh ) - 인제대학교 의과대학 인제대학교 해운대백병원 내과
박종하 ( Park Jong-Ha ) - 인제대학교 의과대학 인제대학교 해운대백병원 내과
최준혁 ( Choi Joon-Hyuk ) - 인제대학교 의과대학 인제대학교 해운대백병원 내과
박용은 ( Park Yong-Eun ) - 인제대학교 의과대학 인제대학교 해운대백병원 내과
이진 ( Lee Jin ) - 인제대학교 의과대학 인제대학교 해운대백병원 내과


Background/Aims: The serum aminotransferase level is usually elevated in rhabdomyolysis, and these enzymes originate from the skeletal muscle. On the other hand, there is limited data showing whether the degree of elevation of these enzymes differs according to the concurrent liver disease.

Methods: Patients with rhabdomyolysis were selected when their serum creatinine kinase level was >1,000 U/L. They were categorized as the group with and without concurrent liver disease. The AST and ALT levels in both groups were compared. In addition, the aminotransferase level was compared between those with rhabdomyolysis and those with alcoholic liver disease.

Results: Among the 165 patients with rhabdomyolysis, 19 had concurrent liver disease. The median peak AST was higher in the group with concurrent liver disease (332 U/L [interquartile range (IQR), 127-1,604] vs. 219 U/L [IQR, 115-504]). In addition, the median peak ALT was higher in the group with concurrent liver disease (107 U/L [IQR, 74-418] vs. 101 U/L [IQR, 56-218]). On the other hand, there was no significant difference in both enzymes between the two groups. The median peak AST level was significantly higher in those with rhabdomyolysis than in those with alcoholic liver disease (221 U/L [IQR, 118-553] vs. 103 U/L [IQR, 59-206]), but the median peak ALT was not significantly different (102 U/L [IQR, 58-222] vs. 51 U/L [IQR, 26-117]).

Conclusions: Rhabdomyolysis showed an elevated AST-dominant aminotransferase level, which is not different according to concurrent liver disease. Therefore, it is recommended that rhabdomyolysis be considered first in cases of elevated aminotransferase levels in patients with a suspicious skeletal muscle injury.


Rhabdomyolysis; Aspartate aminotransferases; Alanine transaminase; Liver diseases
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