| Abstrakt: |
Background:Dengue fever is one of the major viral illnesses in Kerala.It can vary from asymptomatic infection to serious form of disease with organ system failure. Liver is one of the major organs affected. It can be in the form of simple elevation of transaminases or acute liver cell failure. The purpose of this study was to find out the correlation between disease severity and hepatic dysfunction.Material and Methods:The data from 80 patients, admitted in fever wards in our centre, diagnosed with dengue feverwere used in the present investigation. Themaximum numbers of patients belonged to the age group of 40-59 years, and male population was predominant. The liver function tests of the patients were analysed and correlated with the disease severity based on serum bilirubin, albumin, AST, ALT, ALP and INR.Results:Among the study population, maximum patients were in the age group of 40-59 years (36.3%) and males were predominant (55%).11% had severe dengue, 20% had dengue with warning signs and remaining had uncomplicated dengue fever. Bleeding manifestations occurred in only 15%and evidence of fluid accumulation, in 19%. One patient died (case fatality 1.25%). Total bilirubin was elevated in 4% and direct bilirubin in 1%. Hypoalbuminemia was present in 69% of the cases. Both AST and ALT were elevated more than two times the normal (>80 IU) in majority on all days of illness with maximum elevation on days 3 and 4, and decreasing on subsequent days. AST and ALT elevations wereclosely associated with increased severity of the disease on all days of illness. Alkaline phosphatase levels were in near normal range in majority (92.5 %) of the patients and INR was found to be abnormal in only 4% of them.Conclusion:Hepatic dysfunction occurs in majority of the cases of dengue fever; most importantly elevation of the liver enzymes AST and ALT. The severity of the illnessis also closely associated with AST and ALT levels, especially when they are raised more than five times normal (>200 IU). Abnormal INR and bilirubin values arethe other parameters that match withthe disease severity. [ABSTRACT FROM AUTHOR] |
