A STUDY OF EARLY HEPATIC INVOLVEMENT AND OTHER CLINICAL PARAMETERS IN DENGUE FEVER – AN EXPERIENCE IN A TERTIARY CARE CENTRE OF EASTERN INDIA

Abstract

Background: Dengue is a common topical disease with varied presentation ranging from asymptomatic infection to multiple organ dysfunction syndrome (MODS). Aim and Objectives: To study the pattern and severity of early hepatic involvement along with other clinical, biochemical and radiological alterations among a cohort of hospitalized patients with dengue fever on the day of admission. Material and Method: This was a prospective, cross-sectional, observational study included a total of 124 hospitalized patients with dengue fever (NS1Ag positive by ELISA). A detailed history, clinical examination was done. CBC, LFT, USG abdomen and Chest x-ray were carried out on the day of admission. All the study variables were analyzed by appropriate statistical method. Results: Among 124 patients studied, 82 were male and 42 were female. Most common symptom was fever (85.48%) and liver dysfunction was elevated AST (69.35%). Elevation of ALT (41.93%) was always associated with elevated AST. AST values was significantly higher among those with leucopenia (35.48%), thrombocytopenia (58.06%) or both (29.03%) and in all with hepatomegaly. Conclusion: Hepatic dysfunction in the form of raised AST and ALT (>2xUNL) was seen in majority of patients in early phase of dengue fever. Raised AST value was significantly higher than ALT. Early hepatic dysfunction along with cytopenia leads to poor clinical outcome. So, assessment of liver enzymes along with complete blood count at diagnosis of dengue fever is necessary to assess the severity of the disease which will be beneficial in early recognition of high risk cases.