The clinical and biochemical profile of liver involvement in dengue infected patient”. A one year cross sectional study in KLES Dr Prabhakar Kore Hospital & MRC, Belgaum

Abstract

Background and objectives Over the last few years, atypical manifestations of dengue have been described, including elevations in aminotransferase levels, with reactive hepatitis and kidney involvement. The present study was undertaken to assess the clinical and bio-chemical profile of liver involvement in dengue infected patients. Methodology This one year cross-sectional study was carried out in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum. A total of 100 patients who presented with dengue fever from January 2013 to December 2013 were enrolled. Results Most of the patients were male 68% and male to female ratio was 2.12:1. The commonest age group was 18 to 30 years (63%) and the mean age was 30.33 ± 12.63 years. All the patients presented with fever (100%) and next common presentation was generalized body pain (93%). On clinical examination, pallor and icterus were present in 18% and 12% of the patients. Systemic examination revealed, 35% of the patients had hepatomegaly, 16% had pleural effusion and 1% had altered sensorium. Majority (82%) of the patients had raised AST levels and mean AST levels were 460.99 ± 1553.2 IU/L. Raised ALT levels were noted in 71% of the patients and mean ALT levels were 202.77 ± 568.91 IU/L. 27% of the patients had raised total bilirubin levels and mean bilirubin levels were 1.31 ± 1.61 mg/dL. In this study, majority of the patients were diagnosed to have dengue fever (73%) while dengue haemorrhagic fever and dengue shock syndrome were noted in 14% and 13% respectively. Positive association was noted with raised ALT levels and DHF (p=0.016). Also serum bilirubin levels were raised significantly in patients with DHF (p=0.019). Conclusion and interpretation Liver dysfunction in the form of raised ALT and AST levels, and jaundice are common in patients with dengue infection.