Identification of redox markers may be of clinical significance in the management of dengue patients. This study is to identify the association between antioxidant enzymes, hematological parameters and liver transaminases in patients with acute dengue infection. Blood samples were taken from patients on the day of admission, day 05 and 07 from admission for analysis of glutathione peroxidase (GPX), glutathione reductase (GR), aspartate transaminase (AST), alanine transaminase (ALT) and hematological parameters. AST and ALT levels were significantly elevated (p < 0.05) on day 05 in dengue patients. In contrast, GPX and GR showed significantly low levels on day 05 compared to on the day of admission and day 07. Although there was a decline in the trend of platelets towards day 05, values were not significantly different. Dengue associated with liver injury appears to peak around day 05 when the GPX and GR enzymes levels in patients were the lowest suggesting that increased viral load in the acute phase of dengue infection has initiated an antioxidant imbalance. Thus, timely investigation of antioxidant enzymes (GR and GPX) and liver transaminases around day 05 of admission may be of value in the management of patients with dengue infection similar to as seen in platelet counts.
Objective: The aim of the study is to identify whether Atypical Lymphocyte (AL), liver transaminases, and Glutathione Reductase (GR) can be used as potential biomarkers in the assessment of severity and thrombocytopenia in dengue. Methods: A cross-sectional analytical study was carried out on diagnosed dengue patients admitted to Nawaloka Hospital, Sri Lanka. Blood samples were taken from patients (n = 50) on the day of admission, 3 rd and 5 th day from admission for analysis of GR, aspartate transaminase, alanine transaminase, platelets, white blood cells, and Atypical Lymphocytes (AL). Results: GR level of all three measured stages had a higher area under the curve (>88%), high sensitivity and specificity compared to liver transaminases. A significant regression model represents on admission GR and AL levels as predictive variables to platelet levels in day 03 from admission (Day 3 Platelet level = 127155.3 − 383 * GR − 0.431 * AL). Conclusion: Liver transaminases, GR, and AL% can be considered as a profile of predictive biomarkers in early diagnosis of severity of dengue infection. The degree of thrombocytopenia can be predicted using on admission GR and AL% level in acute dengue viral infection.
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