RESUMO
UNLABELLED: Alanine aminotransferase (ALT) elevation in blood donors can be related to many variables such as viral hepatitis, overweight and ethanol consumption. BACKGROUND/AIMS: This study aims to define factors associated with ALT elevation in candidates for blood donation, to evaluate ALT levels during follow-up, and to establish a histological diagnosis of hepatic disease. METHODS: Alcoholism, obesity, drug-induced liver disease, diabetes, hemochromatosis and alpha 1-anti-trypsin deficiency were investigated in 119 subjects (113 males, six females, aged 33.4+/-8.4 years) who were hepatitis B surface antigen/anti-hepatitis C virus negative and had been rejected as blood donors as a result of elevated ALT (>1.5 times the upper normal limit (UNL) in two determinations). During follow-up, ALT was determined every 8 weeks and liver biopsy recommended in cases with persistently elevated ALT levels. RESULTS: Obesity (30.2%) and alcoholism (28.6%) were most frequently associated with ALT elevation and in 9.2% of cases no association was found. ALT levels decreased significantly, regardless of the associated factor. Liver histology in 40 patients showed steatosis (35%), steatohepatitis (30%), non-specific reactive hepatitis (12.5% of cases), normal liver (15% of cases) and alcoholic cirrhosis, hemochromatosis and non-specific portal fibrosis in three cases. CONCLUSION: ALT levels usually dropped during follow-up and although severe hepatic lesions can be found in asymptomatic blood donors, mild hepatic damage is the rule.
Assuntos
Alanina Transaminase/sangue , Alcoolismo/diagnóstico , Doadores de Sangue , Hepatopatias/diagnóstico , Obesidade/diagnóstico , Adulto , Alcoolismo/epidemiologia , Biomarcadores/sangue , Biópsia por Agulha , Brasil/epidemiologia , Estudos de Coortes , Feminino , Humanos , Imuno-Histoquímica , Hepatopatias/epidemiologia , Masculino , Obesidade/epidemiologia , Probabilidade , Medição de Risco , Sensibilidade e EspecificidadeRESUMO
A alanina aminotransferase (ALT)foi introduzida na triagem de doadores de sangue no Brasil a partir de 1994, com finalidade de diminuir o risco de transmissão de hepatites pós-transfusionais, principalmente as hepatites não A, não B. Vários fatores podem estar relacionados á elevação dos niveis de Alt, tais como raça, sexo, idade, peso e consumo de etanol. Este estudo teve como ojetivos definir os fatores de risco associados à elevação de ALT em amostras de candidatos a doador de sangue da Fundação Pro Sangue-Hemocentro de São Paulo, bem como avaliar o comportamento dos níveis de enzimas hepáticas durante período de seguimento, relacionando-os com os fatores de risco e realizar avaliação histopatológica para estabelecer diagnóstico...