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Serum Aminotransferases in Thai Children With Dengue Infection
Olarn Prommalikit1, Usa Thisyakorn2, Chule Thisyakorn2
1Department of Pediatrics, Faculty of Medicine, Srinakharinwirot University, Nakhon-Nayok, Thailand.
Insights
Elevated liver enzymes, particularly aspartate aminotransferase (AST), are common in children with dengue infection. Dengue shock syndrome is associated with significantly higher AST and alanine aminotransferase (ALT) levels.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hepatology
Background:
- Hepatic manifestations are uncommon but recognized complications of dengue infection.
- Understanding these liver abnormalities is crucial for managing dengue patients.
Purpose of the Study:
- To investigate the pattern and sequential changes of serum aminotransferases (AST and ALT) in Thai children diagnosed with dengue infection.
- To compare these liver enzyme levels between children with and without dengue shock syndrome.
Main Methods:
- A prospective study enrolled 127 Thai children with dengue infection.
- Patients were categorized into non-shock and shock groups.
- Serum AST and ALT levels were measured from fever onset and up to 3 days post-shock, analyzed using Student t-test and boxplots.
Main Results:
- Abnormal AST and ALT levels were prevalent in both groups (97.4% AST, 50.0% ALT in shock; 91.8% AST, 44.9% ALT in non-shock).
- Significantly higher aminotransferase levels were observed in the shock group compared to the non-shock group.
- AST levels showed a trend of increase from one day pre-shock, while ALT levels were less affected.
Conclusions:
- Elevated serum aminotransferases are a frequent finding in pediatric dengue.
- Aspartate aminotransferase (AST) levels are generally higher than alanine aminotransferase (ALT) in dengue patients.
- Dengue shock syndrome is linked to significantly elevated aminotransferase levels, with AST increasing up to 3 days post-shock.
Background:
Hepatic manifestations are one of the unusual manifestations of dengue infection.
Objectives:
We conducted this study in order to study the pattern of serum aminotransferases and sequential changes before and after shock in Thai children with dengue infection.
Patients And Methods:
Children who were clinically and serologically diagnosed as dengue infection and were admitted to King Chulalongkorn Memorial Hospital during a peroid of one year were enrolled. They were clinically classified into a non-shock group and a shock group. The majority of serum aminotransferases including aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were obtained within a week after the onset of fever and until 3 days after shock in the shock group. Student t-test and median in boxplot form were used for statistical analysis.
Results:
We enrolled 127 children with a mean age of 7.6 ± 3.6 years. The incidence of abnormal AST and ALT levels was 97.4% and 50.0% in the shock group, and 91.8% and 44.9% in the non-shock group respectively. 29% and 15.4% of the patients in shock group and only 10.2% and 4.1% in non-shock group had the respective AST and ALT levels > 200 U/L. Serum aminotransferase levels were significantly higher in the shock group when compared to the non-shock group. AST tended to increase starting from one day before shock and continued to increase within a few days whereas ALT was less likely to be affected.
Conclusions:
Elevated serum aminotransferases are a common finding in children with dengue infection and the levels of AST are higher than those of ALT. Patients with shock have significantly higher aminotransferase levels that increase up to 3 days after shock.
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