Clinical and laboratory profile in children with dengue viral infection
DOI:
https://doi.org/10.18203/2349-3291.ijcp20221853Keywords:
Dengue, Liver profile, HepatomegalyAbstract
Background: Dengue infection is the most prevalent arthropod borne viral illness in children associated with liver involvement. In recent studies from India and Thailand, dengue infection was the most important cause of acute hepatic failure in children contributing to 18.5% and 34.3% of the cases respectively.
Methods: Hospital based, prospective, observational study in which 120 dengue patients were included in the study. A detailed history and clinical features were recorded on pre-designed proforma. Investigations for dengue and liver function profile were done as per the standard diagnostic work up followed in our hospital.
Results: The result of study shows that out of 120 children, 73 (60.8%) have dengue with warning sign, 46 (38.3%) have dengue fever and 1 (0.8%) have severe dengue. Abdominal pain was most commonly seen in the age group of 8-12 year. 20 (16.7%) cases had hepatomegaly and 27% patients had icterus, 83.3% had thrombocytopenia. In our study liver enzyme and severity of dengue fever were significantly associated, although there was no significant association between age group and liver enzyme. The 17.5% cases of dengue viral infection had elevated prothrombin time, and 19.2% had hypo-proteinemia. There was no significant difference between male and female liver profile. Younger age group and complicated dengue viral infection had more abnormal liver profile.
Conclusions: Hepatic involvement is more common in severe dengue associated with significant rise of liver enzymes. Hepatomegaly is the most important clinical sign but alteration of liver profile can occur with or without hepatomegaly.
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References
Das M. Liver Profile in Children with Dengue Viral Infection. J Dental Med Sci. 2018;17(8):47-9.
Lum LC, Lam SK, George R, Devi S. Fulminant hepatitis in dengue infection. Southeast Asian J Trop Med Public Health. 1993;24(3):467-71.
Chaturvedi UC, Shrivastava R. Dengue Hemorrhagic Fever: A Global Challenge. Indian J Med Microbial. 2004;22:5-6.
Tejaswi CN, Patil SS, Shekharappa KR. Study of clinical manifestations of dengue cases in a tertiary care hospital, Bangalore, Karnataka. Int J Med Sci Public Health. 2016;5:2503-7.
Narayanan M, Aravind MA, Thilothammal N. Dengue fever epidemic in Chennai--a study of clinical profile and outcome. Indian Pediatr. 2002;39(11):1027-33.
Ayesha F, Zahra F, Samina F. Dengue Fever: Hepatic Involvement in Children Up To 12 Years Of Age Professional Med J. 2017;24(11):1605-9.
Goyal V, Ahmed A. Spectrum of hepatic involvement in patients with dengue infection. Int J Med Sci Educ. 2018;5(1):2-6.
Manohar B, Madhavi N. Clinical Profile and Liver Function in Dengue. new Indian J Pediatr. 2015;4(1);15-21.
Halstead SB. Pathophysiology and pathogenesis of dengue hemorrhagic fever. in. thongchareon p, ed monograph on dengue/dengue hemorrhagic fever. New Delhi, World Health Organization, Regional Office for South- East Asia. 1993;80-103.
Bokade CM, Chauhan U, Kamat P. Study of Hepatic Dysfunction in Dengue Fever And It’s Predictor of Outcome. Int J Recent Sci Res. 2016;7(9):13360-63.
Setyoboedi B, Angelika D, Zuraida E, Darmowandowo W, Arief S, Setiono PB. Liver Involvement In Children With Dengue Infection. Folia Medica Indonesiana. 2011;47(4):215-8.
Faridi MM, Aggarwal A, Kumar M, Sarafrazul A. Clinical and biochemical profile of dengue haemorrhagic fever in children in Delhi. Trop Doct. 2008;38(1):28-30.
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(3):127-30.
Wong M, Shen E. The Utility of liver function tests in Dengue. Ann Acad Med. 2008;37(1):82-3.
Khandelwal R, Khandelwal LM, Susheela C. Effect of dengue fever on serum aminotransferases in children. Int J Contemp Pediatr. 2016;3:324-7.
Jagadishkumar K, Jain P, Manjunath VG, Umesh L. Hepatic involvement in dengue Fever in children. Iranian J pediatr. 2012;22(2):231-6.
Tirumani HB, Bejugam VK, Naseem A, Hussain A, Nizarlalani. Study of hepatic involvement in children with dengue infection. Int J Contemp Pediatr. 2017;4:2012-4.
Kamath SR, Ranjit S. Clinical features, complications and atypical manifestations of children with severe forms of dengue hemorrhagic fever in South India. Indian J Pediatr. 2006;73(10):889-95.
WHO. Fact sheet: Sample size determination in health studies: A practical manual, 1991. Available at: https://apps.who.int/iris/handle/10665/40062. Accessed on 1 April 2022.