Dr.S. Sri Latha, Dr.Subba Rao


Objective: To study the spectrum of hepatic involvement in various presentation of dengue fever and predilection of severe forms of dengue fever by early detection of elevated liver enzymes

Methods: This prospective observational study conducted at government hospital,with Ns1ag antigen, and IgM, IgG capture ELISA. Children with pre-existing liver disease and children with other infections causing hepatitis like malaria, hepatitis B, enteric fever, leptospirosis are excluded.

Results: Total 396 cases were included in current study. Males: females were 1.21:1. Fever was present in 100% cases, vomiting in 34.34%, pain abdomen in 51%, arthralgia / myalgia in 44.9%, malena in 12.10% rash in 33.10%.  Hepatomegaly (65.40%) was the most common presentation followed by gallbladder wall edema (54.29%), ascites (44.44%), pleural effusion (34.09%). Mean values of Hb, Hct and platelets were 9.52gm/dl, 36.02%, 38382/cmm respectively. The mean total bilirubin, albumin, AST, ALT, Alk phosphatase level were 1.085mg/dl, 4.95g/dl, 280.69U/L, 178.17 U/L and 146.93 U/L respectively. The mean PT, aPTT, INR, BT and CT were 15.91sec, 37.36sec, 1.04, 6.101 mins and 5.65 mins respectively. Liver function tests AST, ALT and Alkaline phosphatase, bilirubin were deranged in children with severe dengue and dengue with warning signs compared to dengue without warning signs

Conclusion: Our study suggests that significant rise of liver enzymes helps in recognition of severe forms of dengue infection.



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