Hepatic Transaminase Screening in Suspected Child Abuse

An AST or ALT level >80 IU/L had 77% sensitivity and 82% specificity for identifying children with abdominal injury.

Detecting intra-abdominal injury in potentially physically abused children is difficult, because not all children have clinical signs of injury (e.g., abdominal bruising, tenderness, distention). Child abuse experts recommend hepatic transaminase screening to detect injury. In a multicenter observational study, investigators assessed the use of alanine aminotransferase and aspartate aminotransferase screening in 1676 children (age, <5 years) who underwent consultation for physical abuse.

ALT and AST results were obtained in 1272 children (76%), 54 of whom had identified abdominal injury (e.g., radiographic or pathologic evidence of solid organ laceration or contusion). An AST or ALT level >80 IU/L was associated with the best combination of …

Reviewing Author

Howard Bauchner, MD

Disclosures

Grant / research supportHuman Resources and Services Administration; NIH; NIH-NHLBI; USDA; GlaxoSmithKline

Editorial boardsArchives of Disease in Childhood (Editor-in-Chief)

Howard Bauchner, MD

Disclosures

Grant / research supportHuman Resources and Services Administration; NIH; NIH-NHLBI; USDA; GlaxoSmithKline

Editorial boardsArchives of Disease in Childhood (Editor-in-Chief)