Abstract
Serum liver function tests were performed in 22 females, fulfilling the criteria for the TSS. Total serum bilirubin at some point during hospitalization was > 1.0 mg/dl in 18/21 pts. Mean (x) and SD during hospitalization were: 2.3±1.3 mg/dl (n=20) on day #1, 3.1±2.7 (n=14) on day #2, and 2.5±2.1 (n=12) on day #3, respectively, with a maximum (max) level of 11.3 mg/dl in one pt. In 8/16 pts tested, the conjugated bilirubin was > 0.4 mg/dl with a range (R) = 0.5−5.3 mg/dl; x = 1.8±1.6 mg/dl.
Other abnormalities of liver function on the first hospital day included SGOT > 41 U/L in 15/20 pts, max: 300 U/L, x = 103±99 U/L; SGPT > 40 IU/L in 8/10 pts, max: 267 IU/L, x = 92±83 IU/L, and GGT > 55 U/L in 7/9 pts, max: 231 U/L, x = 112.4±61.5 U/L. Serum albumin was < 3.7 g/dl in 16/19 pts, R = 2.3−4.4 g/dl, x = 3.2±0.6 g/dl. Alkaline phosphatase during hospitalization was > 101 U/L in 13/19 pts.
Serum bile salts (BS) were > 10 μMolar in 16/16 pts, R = 12.2 − 147.7, x = 37.8±37.4. These abnormal values for BS are particularly striking, as all pts were essentially fasting.
The 7 pts who required dopamine had significantly higher total serum bilirubin levels during the first two hospital days (t-test of p < .005 and p < .05, respectively). These findings are best explained by both hypoperfusion of the liver and a canalicular injury secondary to staphylococcal exotoxin. Cholestatic features appear to be a universal finding in TSS.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gourley, G., Chesney, P., Davis, J. et al. 1016 CHOLESTASIS IN THE TOXIC-SHOCK SYNDROME (TSS). Pediatr Res 15 (Suppl 4), 612 (1981). https://doi.org/10.1203/00006450-198104001-01042
Issue Date:
DOI: https://doi.org/10.1203/00006450-198104001-01042