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Serumenzyme bei der Mononucleosis infektiosa im Kindesalter

Serum enzymes in infectious mononucleosis in children

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Abstract

70 cases of infectious mononucleosis admitted to the Childrens Hospital, Brno, over a period of 2 years have been studied. The investigation of serum glutamic transaminase (SGOT), glutamic pyruvic transaminase (SGPT), aldolase (ALD), malic dehydrogenase (MDH), total lactic dehydrogenase (LDH), LDH-isoenzymes, total bilirubin and thymol turbidity was carried out as routine test. LDH-isoenzyme determination is of value in detecting any involvement of other organs during the course of infectious mononucleosis. Two types of isoenzymograms are obtained from these cases: the first is characterized by an elevated LDH3, LDH4 activity (typhoidal type of infectious mononucleosis); and the second, where a rise in LDH3, LDH4, LDH5 is prevalent (pharyngeal type with liver involvement; icteric type). The overall picture of the isoenzymograms proves the impairment of the liver and other tissues, particularly those of the lymphoreticular system. A streptococcal infection running concurrently with the infectious mononucleosis, may contribute toward an increasing liver impairment. Characteristic for a liver involvement is the elevation of the slow migrating fraction (isoenzyme LDH5).

Zusammenfassung

Innerhalb von 2 Jahren wurden in die Infektionskinderklinik Brünn 70 Kinder mit infektiöser Mononucleose eingewiesen. Bei diesen Erkrankten bestimmten wir neben den geläufigen Lebertests auch die Aktivität von GOT, GPT, ALD, MDH, LDH und der LDH-Isoenzyme. Bei der Mononucleosis infektiosa (M. i.) finden wir zwei Typen der LDH-Isoenzymogramme. Der erste ist durch das Ansteigen der LDH3- und LDH4-Aktivität bei der typhösen Form charakterisiert. Der zweite ist durch Aktivitätserhöhung der Isoenzyme LDH3, LDH4 und LDH5 bei der anginösen Form und bei der ikterischen Form gekennzeichnet. Dieses kombinierte Isoenzymbild zeugt von einer Leberschädigung sowie gleichzeitig von der Schädigung anderer Organe, vermutlich des lymphoreticulären Systems. Die Schädigung der Leber kann im Verlauf einer M.i. durch eine gleichzeitig auftretende Streptokokkenerkrankung noch verstärkt werden. Für einen Leberschaden ist die Zunahme der langsam wandernden Fraktion charakteristisch, die von dem Isoenzym LDH5 dargestellt wird.

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Authors and Affiliations

  1. Infektionskinderklinik der J. E. Purkyně Universität, Brno, ČSSR

    J. Stejskal & J. Snopková

  2. Biochemische Abteilung des Fakultätskinderspitals in Brno, Brno, ČSSR

    J. Stejskal & J. Snopková

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  1. J. Stejskal
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  2. J. Snopková
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Herrn Professor Dr. med. Vlad. Kluska zum 60. Geburtstag gewidmet.

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Stejskal, J., Snopková, J. Serumenzyme bei der Mononucleosis infektiosa im Kindesalter. Z. Kinder-Heilk. 108, 138–148 (1970). https://doi.org/10.1007/BF00439880

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  • DOI: https://doi.org/10.1007/BF00439880

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