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Tumor necrosis alpha serum levels parallels isolated hypertransaminasemia in the third trimester of pregnancy
Enzo Lerardi
,
Corresponding author
enzo.ierardi@fastwebnet.it

Correspondence and reprint request:
, Marcella Margiotta**, Floriana Giorgio*, Rosa Rosania*, Mariangela Zotti*, Simonetta Prencipe*, Patrizia delli Carri***, Pantaleo Greco***, Carmine Panella*
* Section of Gastroenterology, Department of Medical Sciences, University of Foggia
** Section of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari
*** Gynecology and Obstetrics Section, Department of Surgical Sciences, University of Foggia
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deficiency&#44;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> whilst recently ICP has been associated to a mutation of a gene codifying for xenobiotic receptors&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> An increased release of tumour necrosis factor-alpha &#40;TNF-alpha&#41; in HELLP syndrome has been shown thus suggesting that inflammatory mechanisms may participate in the pathophysiology of this disorder&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Finally&#44; an isolated hypertransaminasaemia &#40;i&#46; e&#46; a significant elevation of transaminases specifically occurring in the 3<span class="elsevierStyleSup">rd</span> trimester of pregnancy in the absence of known liver disorders&#41; may be seen in pregnancy&#46; In order to elucidate a possible mechanism sustaining this rare and vague condition&#44; we correlated serum TNF-alpha levels and isolated hypertransaminasemia of the 3rd&#46; trimester of pregnancy in a prospective study&#46;</p><p id="p0040" class="elsevierStylePara elsevierViewall">Nine women at the 3rd&#46; trimester of pregnancy with isolated hypertransaminasemia &#40;<a class="elsevierStyleCrossRef" href="#t0005">Table 1</a>&#41; were recruited in the period January-December 2007 among a sample of 2&#44;160 pregnant women hospitalized in the Obstetrics Unit of our hospital&#46; In these women&#44; TNF-alpha assay was performed using a direct enzyme linked immunosorbent assay kit &#40;Quantikine human TNF-&#945; ELISA kit&#59; R&#38;D Systems Inc&#46; Minneapolis USA&#41; both during pregnancy &#40;group 1&#41; and 3 months after delivery &#40;group 2&#41;&#46; Thirty pregnants with normal transaminases were used as control &#40;group 3&#41;&#46; Isolated hypertransaminasaemia was confirmed since AFLP was excluded by the absence of specific Glu474Gln mutation detected by real-time polymerase chain reaction in newborn lymphocyte DNA after informed consent of parents &#40;Fermentas International INC Canada 830 Harrington Court&#44; Burlington Ontario&#41; and by the administration a standardized questionnaire to the referring paediatricians to investigate the presence of signs&#47;symptoms of LCHAD deficiency at the 1st&#46; year&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> HELLP was excluded by normal platelet and red blood cell values&#44; ICP by normal bilirubin and bile salts and pre-eclampsia by the absence of hypertension and proteinuria&#46; Finally&#44; negative results were obtained by the exploration of ANAs&#44; HAV-IgM&#44; HBV-DNA&#44; HCV-RNA&#44; minor viruses &#40;cytomegalovirus&#44; Epstein-Barr and Herpes&#41; and alcohol or drug intake history&#46;<elsevierMultimedia ident="f0005"></elsevierMultimedia></p><elsevierMultimedia ident="t0005"></elsevierMultimedia><p id="p0045" class="elsevierStylePara elsevierViewall">Our investigation showed that isolated hypertransaminasaemia prevalence was 0&#46;38&#37; &#40;1&#58; 290&#41;&#44; the raise of transaminase values were significantly higher in group 1 when compared to group 2 and 3 &#40;p &#60; 0&#46;001&#41;&#46; An analogous pattern was observed for TNF-alpha &#40;p &#60; 0&#46;003&#41;&#46; Spearman&#8217;s test showed a strong correlation between transaminase and TNF-alpha serum levels only in pregnant women with hypertransaminasaemia &#40;AST&#58; r &#61; 0&#46;88&#44; p &#60; 0&#46;001&#59; ALT&#58; r &#61; 0&#46;81&#44; p &#60; 0&#46;007&#41;&#44; whilst the correlation was not significant in the control group and three months after pregnancy&#46;</p><p id="p0050" class="elsevierStylePara elsevierViewall">In conclusion&#44; despite hypertransaminasemia of the 3rd&#46; trimester of pregnancy is not a recognized disorder&#44; it represents a finding which likely could be a transient injury of obstetric origin&#44; since it is never been observed in our patients outside the period of pregnancy itself&#46; Our results showed a parallel pattern between serum levels of TNF alpha and transaminases with a simultaneous increase during the 3rd&#46; trimester and a restored normal level after delivery and correlation test confirmed the datum&#46; This&#44; even if obtained in a small number of subjects &#40;the rarity of the condition must be taken into account&#41;&#44; suggests a possible involvement of TNF-alpha in liver damage&#46; Since transaminase raise showed a trend to progressively increase&#44; caesarean delivery was performed in order to avoid the possible progression to known pregnancy-related liver disorders&#44; which represent a relevant risk factor for either the mothers and newborns&#46; Therefore&#44; we cannot be sure that isolated hypertransaminasemia could have been the first sign of one the above mentioned disorders&#46; For these reasons&#44; we believe that only multicentre studies on large series of patients may clarify whether our finding is an interesting result or only a speculative assumption&#46;</p></span>"
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                  \t\t\t\t  " align="center" valign="middle">7&#47;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="middle">21&#47;9&nbsp;\t\t\t\t\t\t\n
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                        "paginaFinal" => "576"
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                        "link" => array:1 [
                          0 => array:2 [
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                      "titulo" => "Increased release of tumor necrosis factor-alpha and interleukin-6 in women with the syndrome of hemolysis&#44; elevated liver enzymes&#44; and low platelet count"
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                          "etal" => false
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                        "tituloSerie" => "Acta Obstet Gynecol Scand"
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Article information
ISSN: 16652681
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es en pt

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