Profile of serum transaminases in patients with dengue infection in a tertiary care hospital

Abstract

INTRODUCTIONDengue ranks among the most important mosquito-borne viral disease in the world. Dengue fever is an acute infectious disease caused by an arbovirus in the Flavivirus genus. It has four serotypes, and the mosquito Aedes aegypti is the vector. While dengue is a global concern, currently close to 75% of the global population exposed to dengue are in the Asia-Pacific region.Dengue virus was isolated in India for the first time in 1945. Over the last few years, atypical manifestations of ABSTRACT Background: Although dengue virus is a non hepatotropic virus, liver injury due to dengue infection is not uncommon. Atypical manifestations with liver involvement have frequently been reported, ranging from mild elevations of aminotransferase levels to fulminant hepatitis. The aim of the present study is to study the serum transaminases level in various forms of dengue infection and correlate with severity. Methods: An analysis of 151 serologically confirmed cases (0-14 yrs) of dengue from June 2017 to July 2017 at a tertiary care hospital, Dharwad was made to assess the frequency and degree of hepatic dysfunction in children with dengue infection by analyzing serum transaminase levels. Patients were classified according to WHO as dengue without warning signs, with warning signs and severe dengue. Patients were divided into primary and secondary dengue based on serology and serum transaminases levels were assessed in each of the above groups. Patients with normal aminotransferase levels were categorized into Grade A, those with atleast one of the enzymes raised to less than 3 times the reference range as Grade B, those with atleast one of the enzymes elevated more than 3 times but less than 10 times as Grade C and those with elevations more than 10 times as Grade D. χ2 test was applied to check statistical significance. Results: During the study period, the total number of serologically confirmed cases of dengue were 151 among which dengue fever without warning signs were 38, with warning signs were 91 and severe dengue were 22. Serum transaminase levels were significantly raised in severe dengue (χ2=14.228, df=6, p=0.027).It was also found that transaminases were significantly higher in secondary dengue infection than primary dengue ( χ2=10.155, df=3, p=0.017). Transaminases were significantly elevated in non-survivors (χ2=16.958, df=3, p<0.001). Conclusions: Hepatic dysfunction was common in all forms of dengue infection, with AST rising significantly more than ALT. Transaminases were significantly elevated in severe dengue and secondary dengue infections. Patients with significantly high transaminases had a poor outcome.

Diagnosis Infeksi Dengue di Era Pandemi COVID-19

“…Adanya cidera terhadap jaringan non-hati oleh infeksi dengue yang sistemik dapat menyebabkan peningkatan SGOT yang lebih tinggi jika dibandingkan dengan peningkatan SGPT. [19][20][21] Tiga penelitian deskriptif pada pasien COVID-19 menunjukkan terdapat 31-35%, dan 24-28% pasien COVID-19 mengalami peningkatan kadar SGOT dan SGPT. 14,15 Persentase peningkatan enzim hati pada pasien COVID-19 lebih didominasi peningkatan SGOT, persentase peningkatan SGOT memiliki rentang 63-97% sementara peningkatan SGPT memiliki rentang yang lebih rendah pada angka 45-97%.…”