Changes of liver and muscle enzymes activity in patients with rigor

Sevastos, Nikolaos; Manesis, Emanuel K.; Savvas, Savvas P.; Galiatsatos, Nikolaos; Papatheodoridis, George V.; Archimandritis, Athanasios J.

doi:10.1016/j.ejim.2007.05.013

« Previous Next »European Journal of Internal Medicine
Volume 19, Issue 2 , Pages 109-114, March 2008

Changes of liver and muscle enzymes activity in patients with rigor

Nikolaos Sevastos
- 2nd Department of Internal Medicine, National University of Athens Medical School, Hippokration General Hospital, 114 Vas. Sophias ave., 11527 Athens, Greece
- Corresponding author. Tel.: +30 210 7774742; fax: +30 210 7706871.
Emanuel K. Manesis
- 2nd Department of Internal Medicine, National University of Athens Medical School, Hippokration General Hospital, 114 Vas. Sophias ave., 11527 Athens, Greece
Savvas P. Savvas
- 2nd Department of Internal Medicine, National University of Athens Medical School, Hippokration General Hospital, 114 Vas. Sophias ave., 11527 Athens, Greece
Nikolaos Galiatsatos
- Biochemical Laboratory, Hippokration General Hospital, Athens, Greece
George V. Papatheodoridis
- 2nd Department of Internal Medicine, National University of Athens Medical School, Hippokration General Hospital, 114 Vas. Sophias ave., 11527 Athens, Greece
Athanasios J. Archimandritis
- 2nd Department of Internal Medicine, National University of Athens Medical School, Hippokration General Hospital, 114 Vas. Sophias ave., 11527 Athens, Greece

Received 25 October 2006; received in revised form 22 March 2007; accepted 10 May 2007. published online 15 January 2008.

Abstract

Aim

We investigated whether changes of liver and muscle enzymes activity are associated with rigor of several causes and have any prognostic significance.

Methods

Seventy-five patients with rigor were prospectively evaluated. Serum enzymes were measured at the onset of rigor and during the three following days.

Results

Causes of rigor were bacteremia (n=28), cholangiitis (n=12), protozoan infections (n=9), viral infections (n=10) and platelet transfusions (n=16). Increases in enzymes activity were observed with rigors from infectious causes, but not with that following platelet transfusions. Patients with cholangiitis demonstrated the highest ALT elevations, while those with viral infections the highest CPK levels. In bacteremia, CPK values increased significantly only in cases with dehydration and hypokalemia.

Conclusions

Rigor per se does not cause increases in muscle or liver enzymes activities. Rather these changes are associated with the rigor's causative agent (infectious or not), the patient's general condition and the severity and extent of the underlying disease.

Keywords: Rigor, Liver enzymes, Creatinophosphokinase, Lactate dehydrogenase, Bacteremia, Infection