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Published on: April 28, 2019
Profile of hepatic involvement by dengue virus in dengue infected children
Amrita Roy1, Debalina Sarkar, Sohini Chakraborty
1Department of Paediatrics, Medical College and Hospitals, Kolkata, West Bengal, India.
Insights
Dengue infection commonly causes liver problems in children, especially severe cases. Jaundice, enlarged liver, and abnormal liver function tests indicate potential dengue, requiring prompt diagnosis in endemic areas.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hepatology
Background:
- Liver dysfunction is a common complication of dengue infection in children.
- The severity of liver involvement correlates with the overall disease severity in dengue.
Purpose of the Study:
- To determine the extent and characteristics of hepatic involvement in pediatric dengue infection.
- To assess the range of liver function abnormalities associated with dengue fever.
Main Methods:
- Studied 120 children (2 months to 14 years) with serologically confirmed dengue fever.
- Classified patients into dengue fever without warning signs, with warning signs, and severe dengue.
- Evaluated clinical signs (hepatomegaly, jaundice) and biochemical markers (AST, ALT, albumin, prothrombin time).
Main Results:
- Hepatomegaly (80.8%) and jaundice (60%) were frequent findings.
- Elevated AST and ALT levels were observed in a significant proportion of patients, particularly in severe dengue groups.
- Reduced serum albumin and prolonged prothrombin time also indicated hepatic compromise.
Conclusions:
- Hepatic dysfunction is prevalent in pediatric dengue, increasing with disease severity.
- Significant elevations in ALT and AST were noted in dengue with warning signs and severe dengue.
- In endemic regions, dengue should be strongly suspected in children presenting with fever, jaundice, hepatomegaly, and abnormal liver function tests.
Background:
The spectrum of liver dysfunction in children with dengue infection is wide and has been associated with disease severity.
Aims:
This study was undertaken to estimate the range of hepatic involvement in dengue infection in children.
Materials And Methods:
This study assessed the biochemical and clinical profile of hepatic involvement by dengue virus in 120 children with serologically positive dengue fever (DF), aged 2 months to 14 years.
Results:
All cases were grouped into DF without warning signs (Group 1), DF with warning signs (Group 2) and severe dengue (Group 3) according to revised World Health Organization 2009 criteria. The spectrum of hepatic manifestations included hepatomegaly (80.8%), hepatic tenderness (46.3%), jaundice (60%), raised aspartate transaminase (AST), alanine transaminase (ALT) and prolonged prothrombin time (41.7%) and reduced serum albumin (56%).
Conclusions:
Hepatic dysfunction was observed more in Groups 2 and 3. There was 84.4% and 93.75% ALT and AST elevation respectively in Group 2 and 94.5% and 95.9% ALT and AST elevation respectively in Group 3 and fulminant hepatic failure was observed in Group 3. Therefore in a child with fever, jaundice, hepatomegaly and altered liver function tests, the diagnosis of dengue infection should be strongly considered in areas where dengue infection is endemic.
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