Spectrum of hepatic dysfunction in 2012 dengue epidemic in Kolkata, West Bengal

Dengue fever (DF) may present as uncomplicated dengue fever, dengue hemorrhagic fever (DHF), or dengue shock syndrome (DSS). Transient intense viremia is responsible for mild, moderate, or severe hepatic dysfunction. Our aim was to evaluate the spectrum of hepatic dysfunction and evidence of plasma leakage in different stages of dengue fever in this epidemic. Detailed history, physical examination, and laboratory evaluation of 1,226 serologically proved dengue patients. Patients with DF were 170 and DHF was 1,056, among which those with ALT ≥ 75 U/L were 43 and 570, respectively. Patients with ALT > 151-300, > 300-450, and > 450 U/L were 186, 77, and 34, respectively. Affected DF (n = 43) and DHF (n = 570) patients presented with symptoms and signs similar to viral hepatitis, but ascites, pleural effusion, raised INR, bleeding, and hypoalbuminemia were present only in DHF patients. In dengue fever, there was a wide range of hepatic dysfunction mimicking acute viral hepatitis.