ELEVATED LIVER ENZYMES IN DENGUE FEVER: IMPLICATIONS FOR DISEASE SEVERITY
Abstract
Background: The spectrum of liver dysfunction in dengue fever varies widely. It is important to gain a comprehensive understanding of liver involvement in dengue fever, focusing on the temporal progression of hepatic function abnormalities. The objectives of this study were to analyze the pattern of liver enzyme abnormalities in patients with dengue fever and its association with the severity of the disease.
Materials & Methods: This descriptive study was conducted at Hayatabad Medical Complex, Peshawar. A total of 180 patients diagnosed with dengue fever were included. Liver enzymes were measured. R-value was calculated using the equation R = ALT/ULN) ÷ ( ALP/ULN). The severity of the disease, as measured by a decline in the Glasgow Coma Scale (GCS) or spontaneous bleeding, was correlated with the R factor. IBM SPSS version 24 was used for the statistical analysis.
Results: The mean age of the patients was 37.23±10.433 years. The number of male participants was 134 (74.4%). Mean ±S.D (Standard deviation) for bilirubin and ALT (alanine transaminase) was 1.21 ±0.582mg/dl, 126.98 ±67.88IU/L respectively. The mean R value was 4.01 ±1.43. Severe disease was observed in 79 patients (43.9%). The odds ratio for R-factor (value >4.3) and the likelihood of severe disease was 11.0 (95% CI 5.5-22.3).
Conclusion: Transaminitis and hypoalbuminemia are biochemical markers of severe dengue disease that may be used to detect and monitor hepatic failure. An R-factor value of more than 4.3 increases the likelihood of severe disease.
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Kalluru PKR, Mamilla M, Valisekka SS, Mandyam S, Calderon Martinez E, Posani S, et al. Aminotransferases in Relation to the Severity of Dengue: A Systematic Review. Cureus 2023;15(5):e39436. https://doi.org/10.7759/cureus.39436
Senaratne T, Carr J, Noordeen F. Elevation in liver enzymes is associated with increased IL-2 and predicts severe outcomes in clinically apparent dengue virus infection. Cytokine 2016; 83:182-8. https://doi.org/10.1016/j.cyto.2016.04.010
Khan U, Azeem S. The rising toll of dengue cases in Pakistan every year: An incipient crisis. Ann Med Surg 2022;76:103549. https://doi.org/10.1016/j.amsu.2022.103549
Suleman M, Faryal R, Alam MM, Zaidi SSZ. Demographic characteristics of dengue virus outbreaks in Khyber Pakhtunkhwa province, Pakistan during 2003-2015. J Formosan Med Assoc 2017;116(9):727-9. https://doi.org/10.1016/j.jfma.2017.02.004
Mohamud MA, Qazi U, Latif A, Khan IU, Anwar S. Dengue Outbreak Response and Control in Khyber Pakhtunkhwa, Pakistan: A Mixed Methods Study. J Epidemiol Glob Health 2020;10(1):74-81. https://doi.org/10.2991/jegh.k.191125.001
Khan J, Adil M, Wang G, Tsheten T, Zhang D, Pan W, et al. A cross-sectional study to assess the epidemiological situation and associated risk factors of dengue fever; knowledge, attitudes, and practices about dengue prevention in Khyber Pakhtunkhwa Province, Pakistan. Front Public Health 2022;10:923277. https://doi.org/10.3389/fpubh.2022.923277
Gandhi K, Shetty M. Profile of liver function test in patients with dengue infection in South India. Med J DY Patil Univ 2013;6:370-2. https://doi.org/10.4103/0975-2870.118269
Swamy AM, Mahesh PY, Rajashekar ST. Liver function in dengue and its correlation with disease severity: a retrospective cross-sectional observational study in a tertiary care center in Coastal India. Pan Afr Med J 2021;40:261. https://doi.org/10.11604/pamj.2021.40.261.29795
Agarwal R, Kapoor S, Nagar R, Misra A, Tandon R, Mathur A, et al. A clinical study of the patients with dengue hemorrhagic fever during the epidemic of 1996 at Lucknow, India. Southeast Asian J Trop Med Public Health 1999;30(4):735-40.
Ray G, Kumar V, Kapoor AK, Dutta AK, Batra S. Status of antioxidants and other biochemical abnormalities in children with dengue fever. J Trop Pediatr 1999;45(1):4-7. https://doi.org/10.1093/tropej/45.1.4
Shah PS, Alagarasu K, Karad S, Deoshatwar A, Jadhav SM, Raut T, et al. Seroprevalence and incidence of primary dengue infections among children in a rural region of Maharashtra, Western India. BMC Infect Dis 2019;19(1):296. https://doi.org/10.1186/s12879-019-3937-z
Samanta J, Sharma V. Dengue and its effects on liver. World J Clin Cases 2015;3(2):125-31. https://doi.org/10.12998/wjcc.v3.i2.125
Bandyopadhyay D, Chattaraj S, Hajra A, Mukhopadhyay S, Ganesan V. A Study on Spectrum of Hepatobiliary Dysfunctions and Pattern of Liver Involvement in Dengue Infection. J Clin Diagn Res 2016;10(5):Oc21-6. https://doi.org/10.7860/JCDR/2016/16946.7784
Tinambunan E, Katu S, Halim R, Mubin A, editors. Correlation between hematologic profile and transaminase enzymes with hospitalization duration dengue. IOP Conference Series: Earth Environ Sci 2018;125(1):012068. https://doi.org/10.1088/1755-1315/125/1/012068
Soni A, Patel P, Malhi N, Avasthi G. Spectrum of liver dysfunction in patients with dengue infection and the markers of severe disease: study from a tertiary care centre in Punjab. J Liver Res Disord Ther 2017;3(4):95-8. https://doi.org/10.15406/jlrdt.2017.03.00063
DOI: https://doi.org/10.46903/gjms/22.01.1454
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