Hepatic enzymes in yellow fever

Q: In life-threatening liver dysfunction due to yellow fever, which liver enzyme tends to have a higher value?

A) alanine aminotransferase (ALT) 
B) aspartate aminotransferase (AST) 


Answer: B 

In contrast to other viral hepatitides, serum aspartate aminotransferase (AST) levels may exceed those of alanine aminotransferase (ALT) by 2 to 3 times. And the severity of enzymes elevation is proportional to the disease severity.

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References:

Tuboi SH, Costa ZG, da Costa Vasconcelos PF, Hatch D. Clinical and epidemiological characteristics of yellow fever in Brazil: analysis of reported cases 1998-2002. 

Trans R Soc Trop Med Hyg 2007; 101:169. Oudart JL, Rey M. Proteinuria, proteinaemia, and serum transaminase activity in 23 confirmed cases of yellow fever]. Bull World Health Organ 1970; 42:95.