Study of hepatic dysfunction in dengue fever

Abstract

Introduction: Hepatic involvement is a common feature in dengue fever, which prolongs the clinical course of this self-limiting viral infection and constitutes assign of worse prognosis, Vomiting and abdominal pain in the early stages point towards hepatic dysfunction. Various studies have shown that in all those patients who develop complications like dengue haemorrhagic fever, dengue shock syndrome, Hepatic failure, ARDS, Renal failure and Septicaemia, the levels of AST and ALT were raised significantly. The severity of hepatic involvement can be a major contributing factor in morbidity and mortality of such patients with Dengue fever. So AST and ALT can be a useful early marker to assess the severity of the disease which can thereby lead to early recognition of high risk cases. Methods: The study is an observational descriptive study conducted at Vydehi Institute of Medical Sciences and Research Centre, Bangalore, in the Department of medicine between Jan 2013- Jan 2015 to study the profile of liver involvement among a group of adult patients suffering from dengue fever and the association of elevated liver enzymes with complications. Detailed history, a complete general physical and systemic examination, with relevant investigations was done on hundred patients as per the proforma. Results: The results were analysed using SPSS-19.A total of 100 patients of dengue fever were studied, out of which seventy patients had elevated AST levels and seventy three had elevated ALT levels. Fever followed by headache was the most common symptoms at presentation while vomiting and pain abdomen in the early stage suggested hepatic dysfunction. AST and ALT were statistically higher in these patients and in those developing complications like DHF, DSS, hepatic failure, ARDS, ARF and encephalopathy. Conclusion: Liver injury is universal in adult patients with Dengue fever. Though liver involvement is asymptomatic in a large majority, in some patients it leads to clinical manifestations. Severity of hepatic involvement can be a major contributing factor in morbidity and mortality of such patients with Dengue fever. So AST and ALT can be a useful early marker to assess the severity of the disease which can thus lead to early recognition of high risk cases.