Role of the detoxification system in aggravation of pseudotuberculosis and development of complicated disease in children

Objective. To analyze possible role of changes in the level of erythrocyte glutathione S-transferase (GST), serum γ-glutamyltransferase (GGT), and serum 5'-nucleotidase (5'-NT) in aggravation of pseudotuberculosis and development of complicated disease in children, as well as to identify prognostic factors to predict complicated pseudotuberculosis. Patients and methods. This prospective study included 125 children with pseudotuberculosis of different severity and disease course and 45 healthy children (control group). We measured the activity of alanine aminotransferase (ALT), aspartate aminotransferase (AST), 5'-NT, GST, GGT, as well as the level of total and conjugated bilirubin. Results. We observed increased levels of ALT, 5'-NT, GST, GGT, and conjugated bilirubin in children with mild and moderate pseudotuberculosis during the acute period, as well as in patients with moderate disease during early convalescence. Children with severe pseudotuberculosis during the acute period and early convalescence demonstrated elevated activity of ALT, AST, 5'-NT, GGT, and maximum increase in the level of bilirubin along with comparable activity of GST. Conclusion. We found that an imbalance of detoxification enzymes in the acute period of pseudotuberculosis has a prognostic value for predicting severe and complicated disease later. Key words: children, pseudotuberculosis, glutathione S-transferase, γ-glutamyltransferase, 5'-nucleotidase