title: Prevalence of leptospira in acute hepatitis syndrome and assessment of IL-8 and TNF-alpha level in leptospiral hepatitis.
abstract: To study the prevalence of leptospira in acute hepatitis syndrome and to assess interleukin (IL)-8 and tumour necrosis factor (TNF)-alpha levels in the pathogenesis of hepatitis due to leptospiral infection. Two hundred and forty-seven consecutive cases with symptoms of acute hepatitis and 30 healthy controls were enrolled in the study and detailed clinical history was elicited from them. Enzyme-linked immunosorbent assays (ELISAs) for HAV, HBV, HCV and HEV were performed to rule out common viral aetiology of hepatitis. IgM antibodies to leptospira were detected by ELISA. IL-8 and TNF-alpha levels were estimated in leptospira-positive cases and healthy controls by ELISA. Out of 247 cases of acute hepatitis, 46 (18.62%) were observed to be positive for IgM antibodies for leptospira. The mean age of these patients was 31.99 ± 0.28 years (25 males and 21 females; M/F ratio: 1.19:1). The mean ALT, AST and ASP were raised in the majority of patients. IL-8 was found to be elevated (130.81 pg/ml) in a large majority of cases 41/46, 89.1% (P < 0.001). Patients with more severe symptoms were associated with higher levels of IL-8. One mortality was observed due to leptospira. Unpredictably, TNF-alpha level was largely suppressed (45.63 pg/ml) in most of the leptospira-positive patients in comparison with healthy controls. Leptospira-induced hepatitis should be actively looked for in patients negative for A-E viral hepatitis. IL-8 appears to play an important role in the pathogenesis of leptospiral hepatitis. High TNF-alpha should alert clinicians for aggressive in hospital management of patients.
authors.affiliation: Department of Microbiology, Faculty of Medicine, J.N. Medical College, Aligarh Muslim University, Aligarh 202002, India. rizvimeher@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Rizvi
authors.forename: M
authors.initials: M
authors.lastname: Azam
authors.forename: M R
authors.initials: MR
authors.lastname: Ajmal
authors.forename: I
authors.initials: I
authors.lastname: Shukla
authors.forename: A
authors.initials: A
authors.lastname: Malik
mesh_terms: D000208:Acute Disease; D000328:Adult; D001663:Bilirubin / Q000097:blood*; D042241:Early Diagnosis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology / Q000276:immunology* / Q000382:microbiology; D006508:Hepatitis Antibodies / Q000097:blood; D006801:Humans; D007194:India / Q000453:epidemiology; D016209:Interleukin-8 / Q000097:blood*; D007919:Leptospira / Q000472:pathogenicity*; D007922:Leptospirosis / Q000453:epidemiology / Q000276:immunology*; D008111:Liver Function Tests; D008297:Male; D015995:Prevalence; D011517:Prothrombin Time; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D006508:Hepatitis Antibodies; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D001663:Bilirubin