Serum Enzyme Abnormalities in Juvenile Rheumatoid Arthritis

Abstract

Elevated serum transaminases, particularly SGOT [serum glutamic oxalacetic transaminase], as a result of acetylsalicyclic acid (ASA) therapy were reported in patients with juvenile rheumatoid arthritis (JRA). To evaluate the possibilities that these elevated transaminases may result from JRA itself or from concomitant muscle injury, liver function tests and a specific test for muscle damage, creatine phosphokinase (CPK), were correlated with ASA therapy in 37 patients. These JRA patients were evaluated serially; 20 took ASA continuously, 6 took it intermittently and 11 were on no therapy. Healthy children (35) were also studied to establish normal control values for the serum enzyme tests. Mean SGOT and SGPT [serum glutamic pyruvic transaminase] in the 11 untreated subjects were significantly (P < .001) higher than normal controls while CPK and alkaline phosphatase (AP) were not elevated. Mean SGOT and SGPT were also significantly (P < .001) elevated in 20 children receiving ASA continuously; CPK was normal and AP less (P < .05) than normal. CPK was elevated in 13 patients. Elevation of enzymes was sporadic and there was no correlation with serum salicylate, sex, age, disease duration, type or activity. Mild abnormalities of SGOT and SGPT in JRA patients are common, but they occur sporadically and elevated values appear to be unrelated to ASA therapy.