Hepatic Involvement in Dengue Fever in Children|
Jagadishkumar, Kalenahalli; Jain, Puja; Manjunath, Vaddambal G. & Umesh, Lingappa
Objective: Hepatic dysfunction is common in dengue infection and the degree of liver dysfunction in children
varies from mild injury with elevation of transaminases to severe injury with jaundice. This study was
undertaken to assess the spectrum of hepatic involvement in dengue infection.
Methods: 110 children with serologically positive dengue fever aged between 2 months - 14 years were
studied for their hepatic functions both clinically and biochemically after excluding malaria, enteric fever,
Hepatitis A and Hepatitis B with relevant investigations.
Findings: All cases were grouped into DF (Dengue fever), DHF (Dengue hemorrhagic fever) and DSS (Dengue
shock syndrome) according to WHO criteria. The spectrum of hepatic manifestations included hepatomegaly
(79%), hepatic tenderness (56%), jaundice (4.5%), raised levels of aspartate transaminase (AST)(93 %),
alanine transaminase (ALT)(78%), alkaline phosphatase (AP) (57%), prolonged prothrombin time (PT)
(20%), reduced levels of serum albumin (66%) and abnormal abdomen ultrasound (65%).
Conclusion: Hepatic dysfunction was observed more in DHF and DSS group compared to DF group. About
17.27% of children had >10 fold increase in the liver enzymes. There was no correlation between the degree
of hepatic enlargement or hepatic tenderness with the abnormalities of liver functions. Any child with fever,
jaundice and tender hepatomegaly in geographical areas where dengue is endemic, the diagnosis of dengue
infection should be strongly considered.
Dengue; Hepatomegaly; Liver enzymes; Children; Jaundice