Study of hepatic involvement in children with dengue infection

Hima Bindu Tirumani; Vinay Kumar Bejugam; Altaf Naseem; Arshad Hussain; . Nizarlalani

doi:10.18203/2349-3291.ijcp20174650

Authors

Hima Bindu Tirumani Department of Pediatrics, Deccan College of Medical sciences, Hyderabad, Telangana, India
Vinay Kumar Bejugam Department of Pediatrics, Deccan College of Medical sciences, Hyderabad, Telangana, India
Altaf Naseem Department of Pediatrics, Deccan College of Medical sciences, Hyderabad, Telangana, India
Arshad Hussain Department of Pediatrics, Deccan College of Medical sciences, Hyderabad, Telangana, India
. Nizarlalani Department of Pediatrics, Deccan College of Medical sciences, Hyderabad, Telangana, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20174650

Keywords:

AST, ALT, Liver dysfunction, Transaminases

Abstract

Background: Liver dysfunction in children is variable and depends on disease severity. This study was undertaken to identify the range of hepatic involvement in children with dengue infection.

Methods: It is a cross sectional observational study conducted in serologically positive dengue fever in children aged between 1-14 years. Hepatic function was studied in all suspected cases over a period of 1 year from June 2015 to June 2016.

Results: Out of 55 cases admitted, liver function tests showed AST levels elevated more than 45U/L in 20 (86.9%) DF, 29 (100%) DHF, 3 (100%) DSS patients. ALT levels were elevated more than 45U/L in 16 (69.5%) DF, 24 (82.75%) DHF, 3 (100%) DSS patients. More than 10 fold increase in levels of both AST and ALT was seen in severe dengue.

Conclusions: Dengue infection is associated with variable levels of liver dysfunction. The incidence of hepatic dysfunction is more in patients with dengue fever with warning signs and severe dengue. Significant elevation of transaminase levels helps in predicting the occurrence of severe dengue. It is important to be aware of this entity which needs significant attention and management.

Metrics

Metrics Loading ...

References

Rigau-Pérez JG, Clark GG, Gubler DJ, Reiter P, Sanders EJ, Vorndam AV. Dengue and dengue haemorrhagic fever. Lancet. 1998 Sep 19;352(9132):971-7.

Kalayanarooj S, Vaughn DW, Nimmannitya S, Green S, Suntayakorn S, Kunentrasai N et al. Early clinical and laboratory indicators of acute dengue illness. J Infect Dis. 1997 Aug 1;176(2):313-21.

Martinez-Torres E, Polanco-Anaya AC, Pleites-Sandoval EB. Why and how children with dengue die? Revista Cubana de Medicina Tropical. 2008;60(1):40-47.

Lum LC, Lam SK, George R, Devi S. Fulminant hepatitis in dengue infection. Southeast Asian J Tropic Med Public Health. 1993 Sep;24(3):467-71.

Nguyen TL, Nguyen TH, Tieu NT. The impact of dengue haemorrhagic fever on liver function. Res Virol. 1997;148(4):273-7.

Poovorawan Y, Hutagalung Y, Chongsrisawat V, Boudville I, Bock HL. Dengue virus infection: a major cause of acute hepatic failure in Thai children. Annals Tropical Paediatr. 2006 Mar 1;26(1):17-23.

Ooi ET, Ganesananthan S, Anil R, Kwok FY, Sinniah M. Gastrointestinal manifestations of dengue infection in adults. Med J Malaysia. 2008 Dec;63(5):401-5.

Kumar R, Tripathi P, Tripathi S, Kanodia A, Venkatesh V. Prevalence of dengue infection in north Indian children with acute hepatic failure. Ann Hepatol. 2008 Jan 1;7(1):59-62.

Hien TT, Vinh NN, Hien PT, Chinh NT, Simmons C, Wills B. Liver involvement associated with dengue infection in adults in Vietnam. The American J Tropic Med Hygiene. 2010 Oct 5;83(4):774-80.

Butt N, Abbassi A, Munir SM, Ahmad SM, Sheikh QH. Haematological and biochemical indicators for the early diagnosis of dengue viral infection. J Coll Physicians Surg Pak. 2008;18:282-285.

Mohan B, Patwari AK, Anand VK. Hepatic dysfunction in childhood dengue infection. J Trop Pediatr. 2000;46:40-43.

Pancharoen C, Rungsarannont A, Thisyakorn U. Hepatic dysfunction in dengue patients with various severity. J Med Assoc Thai. 2002;85 Suppl 1:S298-301.

Wahid SF, Sanusi S, Zawawi MM, Ali RA. A comparison of the pattern of liver involvement in dengue haemorrhagic fever with classic dengue fever. Southeast Asian J Trop Med Public Health. 2000;31:259-263.

Itha S, Kashyap R, Krishnani N, Saraswat VA, Choudhuri G, Aggarwal R. Profile of liver involvement in dengue virus infection. Natl Med J India. 2005;18:127-130.

Chongsrisawat V, Hutagalung Y, Poovorawan Y. Liver function test results and outcomes in children with acute liver failure due to dengue infection. Southeast Asian J Trop Med Public Health. 2009;40:47-53.

Faisal T, Taib MN, Ibrahim F. Reexamination of risk criteria in dengue patients using the self-organizing map. Med Biol Eng Comput. 2010;48(3):293-301.

Kuo CH, Tai DI, Chang-Chien CS, Lan CK, Chiou SS, Liaw YF. Liver biochemical tests and dengue fever. Am J Trop Med Hyg. 1992;47:265-270.

Nguyen TL, Nguyen TH, Tieu NT. The impact of dengue haemorrhagic fever on liver function. Res Virol. 1997;148:273-7.

de Souza LJ, Nogueira RM, Soares LC, Soares CE, Ribas BF, Alves FP, et al. The impact of dengue on liver function as evaluated by aminotransferase levels. Braz J Infect Dis. 2007;11:407-410.

Kalayanarooj S, Nimmannitya S. Clinical presentations of dengue hemorrhagic fever in infants compared to children. J Med Assoc Thai. 2003;86 Suppl 3:S673-680.

Roy A, Sarkar D, Chakraborty S, Chaudhuri J, Ghosh P, Chakraborty S. Profile of hepatic involvement by dengue virus in dengue infected children. North Am J Med Sci. 2013 Aug;5(8):480-5.

Jagadishkumar K, Jain P, Manjunath VG, Umesh L. Hepatic involvement in dengue fever in children. Iranian J Pediatr. 2012 Jun;22(2):231-6.