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Protocol for Dengue Infections in Mosquitoes A. aegypti and Infection Phenotype Determination
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Clinical Profile, Liver Dysfunction and Outcome of Dengue Infection in Children: A Prospective Observational Study

Durga Prasad1, Arpita Bhriguvanshi

  • 1Department of Pediatrics King George's Medical University Lucknow 226003, Uttar Pradesh, India.

The Pediatric Infectious Disease Journal
|December 10, 2019
PubMed

Insights

Severe hepatitis in children with dengue is linked to worse outcomes, including organ dysfunction and death. Monitoring liver function tests helps predict disease progression and identify high-risk patients.

Area of Science:

  • Pediatric infectious diseases
  • Hepatology
  • Clinical virology

Background:

  • Liver involvement is a common complication of dengue illness, potentially leading to acute liver failure (ALF).
  • Current methods are insufficient for identifying pediatric dengue patients at risk of severe disease progression and adverse outcomes.
  • Understanding the role of liver dysfunction and liver function test (LFT) kinetics is crucial for managing pediatric dengue.

Purpose of the Study:

  • To investigate the relationship between liver dysfunction, the dynamic changes in liver function tests (LFTs), and the severity of hepatitis.
  • To determine the impact of these liver-related factors on clinical outcomes in pediatric dengue patients.

Main Methods:

  • A prospective observational study was conducted on 102 hospitalized children aged 1-12 years with confirmed dengue infection.
  • Serial monitoring of LFTs was performed, and patients were categorized into non-severe dengue (NSD) and severe dengue (SD) groups.
  • Hepatitis severity was graded (mild, moderate, severe), and clinical events during hospitalization were recorded.

Main Results:

  • Elevated transaminases (AST/ALT) were observed in 92% of patients, peaking around day 5 of illness.
  • Severe hepatitis was significantly more common in the severe dengue group (100% vs. 80%) and strongly associated with organ dysfunction (altered sensorium, ALF, AKI, shock).
  • Severe hepatitis and shock at presentation independently predicted ALF and mortality, with high odds ratios.

Conclusions:

  • Pediatric dengue frequently involves liver dysfunction.
  • Severe hepatitis in dengue is a significant predictor of poor outcomes, including organ dysfunction and increased mortality.
  • Early identification of severe hepatitis is critical for timely intervention in pediatric dengue cases.
Abstract

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