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A Study of Serum Aminotransferase Levels in Dengue Fever and Its Correlation with Clinical Profile
Dr Jeet Shah, Dr Bishal Sharma, Dr Mahendra C Parmar, Dr Priya Kuwar
DOI : 10.5281/zenodo.7838740
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BACKGROUND: Dengue fever is one of the world’s most common viral hemorrhagic fever diseases, the most geographically widespread of the arthropod-borne virus illnesses. Caused by arbovirus of Flavivirus genus with 4 serotypes. It is transmitted by Aedesaegypti, Aedesalbopictus. 4 spectra of illness are seen; an asymptomatic phase, acute febrile illness, classic Dengue fever (DF), Dengue Hemorrhagic Fever (DHF) which includes Dengue Shock Syndrome (DSS). Dengue viral infection has been recognized as one of the world’s biggest emerging epidemics. Throughout the tropics this infection has an annual incidence of 100 million cases of DF with another 2, 50,000 cases of DHF and mortality rate of 24000-25000 per year. The involvement of liver in dengue fever has not been uncommon as reported in literature since 1970. Liver and nervous system involvement simultaneously predicts poor outcome in dengue fever. Atypical manifestations include liver involvement with elevation of enzymes, central nervous involvement (encephalopathy) and cardiac alterations (myocarditis). Liver involvement in dengue fever is manifested by the elevation of transaminases representing reactive hepatitis, due to direct attack of virus itself or the use of hepatotoxic drugs. MATERIALS AND METHODS: The study was performed on patients admitted for dengue fever in Medical College, Baroda. The total duration of the study was 10 months. INCLUSION CRITERIA: Dengue IgM positive EXCLUSION CRITERIA: Age <18 years, Chronic liver disease, Viral hepatitis (Hepatitis. A, Hepatitis. B, Hepatitis. C), Malaria, Leptospirosis, Typhoid, History of alcohol abuse. RESULTS: 85 patients reactive for dengue virus specific IgM/NS1 were studied. As per WHO classification, 39(45.88%) patients were classified as dengue without warning signs,32(37.65) patients as dengue with warning signs and 14(16.47) as severe dengue. Mean age of dengue infection was 23yrs with standard deviation of 8years with female predominance. Hepatic dysfunction is very common in all forms of dengue infection with AST rising significantly more than ALT. xi Serum aminotransferase levels appear to have a direct proportional correlation with grading of dengue infection. CONCLUSION: Serum aminotransferase levels are significantly raised in all forms of dengue infection, and it directly correlates with severity of infection. Serum aspartate aminotransferase was significantly raised compared to alanine aminotransferase levels in all forms of dengue infection. The degree of affection of serum albumin and prothrombin time which are absolute indicators of liver cell function correlated with severity of dengue infection.

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