Study of hepatic dysfunction in dengue fever

 

 

Abstract                                                           Background: Dengue Fever has been recognized as one of the fastest spreading arboviral infection worldwide. Its manifestations can be benign in its classical form and serious in Dengue Haemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS), also may involve multi-organ system. The objective of this study was to determine the incidence of Hepatic dysfunction in patients with Dengue Fever and assess the prognostic implications of hepatic dysfunction. Materials And Methods: This study is a hospital based prospective study done over a period of one and half years on 100 subjects of Dengue Fever, selected randomly and included in the study based on inclusion and exclusion criteria. A detailed history was taken, clinical examination and investigations were done and details entered in a structured proforma. The data collected was transferred into a Master Chart which was subjected to statistical analysis. Patients were categorized into mild, moderate and severe Hepatitis group based on aminotransferase levels. Results: Total of 100 Dengue cases were included in the study out of which 52 were males and 48 were females. Mean age of the patients was 41.7 years. Based on WHO criteria, 5 patients had DHF, 2 were diagnosed as DSS and remainder 93 had classical dengue fever. Out of 100 patients, Hepatic dysfunction was seen in 85% of patients with aminotransferase levels being elevated, 40% had mild hepatitis, 34% had moderate and 11% had severe hepatitis. There was no statistically significant correlation between Length of Hospital Stay and severity of Hepatitis. There were 3 deaths due to Dengue during the course of study with 2 patients having moderate hepatitis and 1 having severe hepatitis and there was no statistical significance between mortality and severity of hepatitis. Conclusions: In this study, we conclude that Hepatic dysfunction is seen in most of the patients with dengue fever and should be considered as one of the differentials for acute febrile illness with hepatitis. However, the prognostic significance of liver function tests in Dengue fever needs to be determined by larger studies.

Key Words: DHF; Dengue Hemorrhagic Fever, DSS; Dengue Shock Syndrome, Hepatic Dysfunction, Length of Stay, Thrombocytopenia.