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Liver function test results and outcomes in children with acute liver failure due to dengue infection

Voranush Chongsrisawat1, Yanee Hutagalung, Yong Poovorawan

  • 1Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University and Hospital, Bangkok, Thailand.

The Southeast Asian Journal of Tropical Medicine and Public Health
|March 28, 2009
PubMed

Insights

Children with acute liver failure (ALF) from dengue hemorrhagic fever (DHF) showed higher AST than ALT levels. While not statistically significant, DHF patients had a lower mortality rate compared to other ALF causes.

Area of Science:

  • Pediatrics
  • Hepatology
  • Infectious Diseases

Background:

  • Acute liver failure (ALF) in children presents a significant clinical challenge.
  • Dengue hemorrhagic fever (DHF) is a notable cause of ALF in endemic regions.
  • Understanding the specific characteristics and outcomes of DHF-related ALF is crucial for pediatric care.

Purpose of the Study:

  • To compare liver function tests and clinical outcomes in pediatric ALF patients.
  • To differentiate outcomes between ALF caused by DHF and other etiologies.
  • To identify factors influencing mortality in pediatric ALF.

Main Methods:

  • Retrospective cohort study of pediatric ALF patients (<15 years) across multiple Thai centers (2000-2001) and one center (1997-2004).
  • ALF diagnosis criteria: PT > 2x normal and encephalopathy without prior liver disease.
  • Patients categorized into DHF-ALF (Group I) and other causes-ALF (Group II).

Main Results:

  • DHF-ALF patients exhibited significantly higher AST levels compared to ALT levels.
  • Mortality rates were 50% for DHF-ALF and 72.9% for other causes-ALF (not statistically significant).
  • Non-DHF patients who died had longer jaundice duration and higher PT ratios than survivors; no such difference found in DHF patients.

Conclusions:

  • Pediatric ALF due to DHF may have a potentially better, though not statistically significant, survival outlook compared to other causes.
  • Liver function test patterns (AST>ALT) may be characteristic of DHF-related pediatric ALF.
  • Prognostic indicators for non-DHF pediatric ALF differ from those with DHF-ALF.

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