Study of Serum Aminotransferase Levels in Dengue Fever (original) (raw)
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The impact of dengue on liver function as evaluated by aminotransferase levels
Brazilian Journal of Infectious Diseases, 2007
The objective of this study was to evaluate the impact of dengue virus infection on liver function by measuring aminotransferase in blood samples from patients serologically diagnosed by according to two MAC-ELISA protocols. Degrees of liver damage were classified according to aminotransferase levels: grade A normal enzyme levels; grade B increased levels of at least one of the enzymes; grade C increased, with at least one of the enzymes being at levels higher than three times the upper reference values; grade D acute hepatitis, with aminotransferase levels at least ten times their normal values. Of the 169 serologically confirmed cases of dengue at the dengue referral center in Campos dos Goytacazes in the state of Rio de Janeiro, Brazil, 65.1% had abnormal aminotransferase levels: 81 cases being classified as grade B, 25 as grade C and 3 as grade D. A further 34.9% of cases had normal enzyme levels and were classified as grade A. Liver damage is a common complication of dengue infection and aminotransferase levels are a valuable marker for monitoring these cases.
Aminotransferase changes and acute hepatitis in patients with dengue fever: analysis of 1,585 cases
Brazilian Journal of Infectious Diseases, 2004
Introduction: Type 3 dengue virus caused an extensive epidemic in the state of Rio de Janeiro in summer 2002. In some of the patients, it was found in an atypical form with increased aminotransferase levels and acute hepatitis. Material and Methods: An analysis was made of 1,585 serologically confirmed dengue cases at the Dengue Reference Center in Campos dos Goytacazes, Rio de Janeiro state. The grade of hepatic aggression was established according to the alterations in the aminotransferase levels: grade A -normal levels of aminotransferase; grade B -elevated aminotransferase, with increased levels of at least one of the enzymes; grade Celevated aminotransferase, with the levels of at least one of the enzymes increased to more than three times the reference values; grade D -acute hepatitis, with aminotransferase levels increased to at least 10 times their normal values. Results: Among the 1,585 serologically confirmed dengue cases, 44.5% presented alterations in the aminotransferase levels (grade B), 16.9% presented grade C liver involvement and 3.8% of the patients had progressed to acute hepatitis (grade D). The average values for the rise in aspartate aminotransferase and alanine aminotransferase were 93.3 U/L and 86.0 U/L. The greatest alterations were observed among females (p<0.001), cases of dengue hemorrhagic fever (p<0.001), and cases with sequential infections (p=0.001). Conclusions: Liver damage with elevation of aminotransferases and reactive hepatitis was a common complication of dengue virus infection in these patients.
Correlation of Severity of Dengue Fever with Serum Transaminase Levels: A Retrospective Study
Journal of Medical Science And clinical Research, 2017
Dengue infection is a major health problem worldwide including our country. Dengue, one of the most rapidly spreading mosquito-borne viral diseases in the world, is an acute infection caused by an arbovirus in the Flavivirus genus, and the mosquito Aedes aegypti is the vector. Epidemic dengue is a major public health problem in South East Asia, especially in India where there is a reported case fatality ratio of 3-5%. One of the most prominent clinical characteristics of dengue patients is increased aspartate and alanine aminotransferase liver enzyme levels. The significance of this is uncertain, as it is transient in the majority of cases, and most patients recover uneventfully without liver damage. Methods and Material: This study included 42 patients of dengue positive cases admitted in RL Jalappa hospital, Tamaka Kolar, Karnataka. We included all patients diagnosed dengue positive in this study. Excluded based on exclusion criteria. Results: Among 42 patients enrolled, males comprised 71% (30), females 29% (22) of the study population and median age of study population was 32 years (25-45 years). 21% (9) had dengue fever without warning signs, 62% (26) had dengue with warning signs and 17% (7) had severe dengue. The main presenting symptoms were fever (100%) followed by myalgia (54.2%), arthralgia (53%), hemorrhagic manifestations (46.4%), vomiting (40.4%) and abdominal pain (27.1%). Hepatomegaly was observed in 11.4% patients in this study. Among 42 patients 90.4% (38) patients were positive for NS1Ag, IgM 71.4% (30), 33.3 % (14) and IgG and NS1Ag 59.52 % (25). In our study 12 patients had normal level of serum transaminases (grade A, 28.5%), 30 (71.4%) had elevated enzymes in which 17 falling into the grade B (40.4%), 10 in grade C (23.3%) and 3 in the group D (7.1%). Among 30 patients with raised serum transaminases all had elevated AST whereas only 24 (80%) had elevated ALT. Mean AST value was 396 ± 746 IU/L and mean ALT was 285 ± 460 IU/L. The characteristics of ALT and AST among study population is as shown below in the table. Conclusion: In conclusion, all serologically confirmed dengue infection patients, liver involvement in the form of elevation of transaminases levels occurred in almost all patients. However, association with the severity of the disease could not be sought due to the small sample size. Most of our patient developed jaundice and acute hepatitis but most patient had mild to moderate effect and recovered with supportive treatment. Care must be taken not to make a mistaken diagnosis of viral hepatitis.
Profile of liver function test in patients with dengue infection
2016
Background: Atypical manifestations of dengue infection with liver involvement have frequently been reported, ranging from mild elevations of aminotransferase levels to fulminant hepatitis. Materials and Methods: An analysis of 27 serologically confirmed cases of dengue infection at our tertiary care hospital was made. Patients with normal aminotransferase levels were categorized into Grade A, those with at least one of the enzymes raised to less than 3 times the reference range as Grade B, those with at least one of the enzymes elevated more than 3 times but less than 10 times as Grade C and those with elevations more than 10 times as Grade D. Results: 89% of the cases had alterations in the aminotransferase levels, with 37% categorized into Grade B, 30% into Grade C, and 22% as Grade D or acute hepatitis (P < 0.001). Aspartate aminotransferase (AST) levels were higher compared to the levels of alanine aminotransferase (ALT) (mean: 390.7 U/l and 296.9 U/l, respectively). Conclus...
Alanine Transaminase levels in Patients of Dengue Fever in the Suburbs of Islamabad
Journal of Rawalpindi Medical College
Introduction: Hepatic dysfunction is a highly varied condition that can show up as minor damage with elevated levels of transaminases, or appear as extensive damage and failure of liver cells. Thus, in order to reduce associated morbidity and mortality, this ailment should be diagnosed at the earliest possible so that appropriate therapy can be instituted. Our study was carried out to observe hepatic damage in patients with dengue fever (DF) by measuring alanine transaminase levels. Materials and Methods: A cross-sectional study of three months duration was carried out in the Department of Medicine, Dr. Akbar Niazi Teaching Hospital affiliated with Islamabad Medical & Dental College, Pakistan. The sampling technique was Non-Random consecutive sampling and 118 patients were included in our study. Serum Alanine Transaminase (ALT) (normal = 7-56 IU/L), serum Aspartate Transaminase (AST) (normal = 10-40 IU/L) were determined and ultra-sound abdomen was performed. Statistical analysis wa...
Study of liver enzyme variation in children with dengue fever
International Journal of Contemporary Pediatrics
Background: Dengue fever continues to be one of the major public health problems in large parts of the world, with an estimated 50 million dengue infections occurring annually. Liver enzyme variation is commonly seen in patients with dengue fever. This study was undertaken to assess the pattern of liver enzyme variation in children with dengue fever and to correlate it with the severity of this disease.Methods: Observational, descriptive hospital-based study involving 100 children who were serologically positive for dengue fever. The cases were classified as Mild, Moderate and Severe Dengue based on National Guidelines of clinical management of Dengue fever, 2015 and severity was assessed in each category. The study assessed the variability of liver enzymes in these children.Results: Aspartate Aminotransferase (AST) was elevated in 56 cases whereas Alanine Aminotransferase (ALT) was elevated in 44 cases. The elevation in liver enzymes in mild cases was 52%, moderate cases was 75% an...
e-CliniC, 2016
Dengue infection still one of the global health problem. Hepatic dysfunction is common in dengue infection and the spectrum of liver dysfunction in children with dengue infection is wide and has been associated with disease severity. Hepatic dysfunction can be measured with aminotransferase levels. Significant rise of aminotransferase level helps in recognition of severe form of dengue infection. This study aimed to obtain the profile of aminotransferase levels of children diagnosed with dengue infection. This was a descriptive retrospective study using medical record data of patients in Pediatrics Department Prof. Dr. R.D. Kandou Hospital Manado. There were 432 patients with dengue infection during the period 2011-2016. Patients performed liver function test were 222 patients, however, only 183 patients that meet the inclusion criteria. All cases were grouped into Dengue Fever (DF), Dengue hemorrhagic fever (DHF) and Dengue shock syndrome (DSS) according to WHO criteria. Most patient diagnosed with DSS. Aminotransferase levels rise more significant in DSS and DHF group compared to DF group. AST was elevated more than ALT.
A Study on Liver Enzymes as an Early Predictor of Complicated Dengue Fever
IOSR Journals , 2019
BACKGROUND Dengue Fever(DF) has an unpredictable clinical course which leads to a policy of indiscriminate referral to higher centres from peripheral centres. Diagnosing dengue early is challenging because the initial symptoms are non specific and serological tests can confirm dengue only late in the course of illness. Only few studies have been done on hepatic involvement in paediatric DF. OBJECTIVES 1. To determine whether elevated liver enzymes can be used as an early predictor of DF. 2. To predict the prognosis of the disease according to the degree of elevation of liver enzymes. METHOD This is a prospective cohort study in paediatric patients admitted with fever and thrombocytopenia during the study period .SGOT, SGPT levels at the time of admission (from day 2-6 of fever) were estimated. All the patients were followed up and IGM dengue test was done after 6 days of fever. RESULTS A total of 200 patients were included in the study .76 patients (38%) had SGOT elevation of 2-5 times. 69 (35%) had <2 times elevation. 29(15%) had very severe elevation of 5-15 times and 26 (13%) had normal SGOT levels .An SGOT enzyme elevation of 5-15 times was associated with 93 %IGM Dengue positivity, with a p value of <0.01. A positive correlation was found between severity of disease and degree of elevation of SGOT and thrombocytopenia, both with a significant p value of <0.05
International Journal of Contemporary Pediatrics
Background: Hepatic involvement is not an uncommon in dengue viral infection, which presents with elevation in serum aminotransferases due to reactive hepatitis. The study is aimed to know the pattern of changes in hepatic enzyme levels in dengue infection in pediatric patients and to assess it with clinical presentation of dengue in particularly patients without and with shock.Methods: Pediatric patients with serologically confirmed Dengue viral infection were enrolled in the study and divided clinically into a shock group and a non-shock group. SGPT and SGOT levels were measured from day one of fever onset till 7 days and within 3 days after shock in the shock group. Student t-test was used to analyze the statistical data.Results: 100 patients with a mean age of 8±2.6 years were included in the study. The incidence of abnormal SGOT and SGPT levels were 96.9% and 51.1% in the shock group, and 92.2% and 45% in the non-shock group respectively. 30% and 17.9% of the patients in shock ...
Hepatic Dysfunction in Dengue Fever-A Prognostic Indicator
Background: Dengue fever is a tropical infection, presenting with a wide range of clinical manifestations. Hepatic dysfunction in dengue fever is not uncommon, and may lead to fulminant liver failure. This study aims to evaluate the hepatic dysfunction in dengue fever and assess the prognostic value of serum transaminases in determining the severity of dengue. Materials and Methods: This prospective study was carried out at Bhagwan Mahaveer Jain Hospital, Bangalore, Karnataka, from September 2018 to September 2019. A total of 165 adult patients (both male and female), aged ≥18 years, who tested positive for dengue NS1 antigen or dengue serology (IgM/IgG) were included. Liver function tests were sent for all patients. Patients with elevated serum transaminases were classified into mild elevation (two fold increase), moderate elevation (three to four fold increase) and severe elevation (greater than 4 fold increase) Results: The mean age was 33.43 ± 12.70, with 56.4% males. Fever (100%) and headache (74.5%) were the most common symptoms reported. Bleeding manifestations were seen in 27.2% patients. 93.9% patients had elevated AST and 83.6% had elevated ALT. Patients with severe elevation of AST and ALT had more complications, manifesting as Dengue Shock Syndrome (DSS), Dengue Hemorrhagic Fever (DHF) and prolonged hospital stay. Conclusion: The study shows the presence of hepatic dysfunction in majority of the patients with dengue fever, as evidenced by the elevation of AST/ALT enzymes. Patients with severe elevation of serum transaminases have prolonged hospital stay and severe complications of dengue (DHF, DSS, thus indicating increasing morbidity and poor prognosis.