RESUMO
The aim of this controlled cross-sectional study was to assess the clinical validity of elevated values of three clinically relevant transferase enzymes (aspartate transaminase [AST], alanine transaminase [ALT], and gamma-glutamyl transferase [GGT]) induced by imported infectious diseases (IDs) seen among patients consulting the Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (from 1999 to 2014) after being in the sub-/tropics. Data sets of 14,559 diseased German travelers returning from Latin America (2,715), Africa (4,574), or Asia (7,270) and of 1,536 healthy controls of German origin without recent travels were analyzed. Among the cases, the proportions of those with elevated values of AST (7.8%) and of ALT (13.4%) were significantly larger than among controls (4.0% and 10.6%, respectively), whereas for GGT, no significant difference was found (cases: 10.0%; controls: 11.4%). The study identified IDs with significantly larger proportions of both AST and ALT (hepatitis A [100%/100%], cytomegalovirus [CMV] infection [77%/81%], chronic hepatitis C [67%/67%], infectious mononucleosis [65%/77%], typhoid fever [50%/50%], cyclosporiasis [45%/66%], dengue fever [43%/35%], malaria [20%/27%], and rickettsiosis [20%/24%]), of AST alone (paratyphoid fever [42%]), of ALT alone (giardiasis [20%]), and of GGT (hepatitis A [100%], infectious mononucleosis [71%], CMV infection [58%], rickettsiosis (20%], and dengue fever [19%]). The study demonstrates that the determination of AST and ALT among travelers returning from the sub-/tropics has a high clinical validity, as their elevated values are typically caused by several imported viral, bacterial, and protozoan IDs, whereas no additional clinical validity was found by the determination of GGT.
Assuntos
Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Ciclosporíase/epidemiologia , Infecções por Citomegalovirus/epidemiologia , Dengue/epidemiologia , Hepatite A/epidemiologia , Hepatite C Crônica/epidemiologia , Mononucleose Infecciosa/epidemiologia , Malária/epidemiologia , Infecções por Rickettsia/epidemiologia , Febre Tifoide/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos Transversais , Ciclosporíase/sangue , Ciclosporíase/diagnóstico , Infecções por Citomegalovirus/sangue , Infecções por Citomegalovirus/diagnóstico , Dengue/sangue , Dengue/diagnóstico , Feminino , Alemanha/epidemiologia , Hepatite A/sangue , Hepatite A/diagnóstico , Hepatite C Crônica/sangue , Hepatite C Crônica/diagnóstico , Humanos , Lactente , Mononucleose Infecciosa/sangue , Mononucleose Infecciosa/diagnóstico , Malária/sangue , Malária/diagnóstico , Masculino , Pessoa de Meia-Idade , Infecções por Rickettsia/sangue , Infecções por Rickettsia/diagnóstico , Viagem , Medicina Tropical , Febre Tifoide/sangue , Febre Tifoide/diagnóstico , gama-Glutamiltransferase/sangueRESUMO
In Cyclospora cayetanensis oocyst-positive patients, T cell subsets in peripheral mononuclear cell and membrane interleukin-2 receptor (mIL-2R) were detected with the method of biotin-streptavidin (BSA) and soluble interleukin-2 receptor (sIL-2R) as well as special IgG, IgM in serum was detected by ELISA. Results showed that there is a significant difference between the infected and uninfected individuals.