Serum transaminase levels and dengue shock syndrome in children

Abstract

Background Clinical and biochemical impacts on liverdysfunction, as manifested by an increase in serum transaminaselevels, are common in dengue infection. Howevei; an association ofelevated serum transaminase and dengue shock syndrome (DSS)has n ot been well-established.Objective To assess for an association between serum transaminaselevels and the presence of DSS in children.Methods A nested, case control study was conducted on childrenaged l month to 12 years admitted to Sanglah Hospital whowere diagnosed with dengue infection. Baseline characteristicsand serum transaminase levels were recorded. Patients who wereincluded in the study were observed for the presence of DSS.Those who had DSS were selected as cases, and those who did notdevelop DSS were selected as controls. Data was analyzed usingbivariate and multivariate methods with 95% confidence intervalsand P value <0.05 was considered as statistically significant.Results Ninety-four children were involeved, 4 7 children in thecase group and the other 4 7 were in the control group. Baselinecharacteristics of the subjects were similar between the case andcontrol groups. Serum aspart ate transaminase (AST) level of2:: 128 U/L and alanine transaminase (ALT) of 2: 40 U/L wereassociated with DSS (OR 10; 95%CI 2.3 to 44.4; P=0.002) and(OR 7 .3; 95%CI 1.6 to 32.9; P= 0.009), respectively.Conclusion Elevated AST and ALT levels were associatedwith an increased risk of DSS in children with dengue infection.

Obesity as a clinical predictor for severe manifestation of dengue: a systematic review and meta-analysis

“…twelve studies applied the WHO 1997 classification for dengue severity. Included studies were conducted from 1995 to 2020 in endemic areas of Asia (Thailand, [ 32 , 38 , 40 , 42 , 45 ] Indonesia, [ 31 , 33 , 34 , 37 , 39 , 41 , 43 , 44 ] Malaysia [ 36 ]) and Latin America (Paraguay [ 35 ]).…”

“…The overweight or obese status was defined using body weight or body weight-for-age in five studies [ 32 , 34 , 38 , 40 , 42 ]; body mass index (BMI) or BMI-for-age in four studies [ 36 , 39 , 43 , 45 ] and weight/height% in one study [ 37 ]. Other five studies did not specify the criteria for obesity [ 31 , 33 , 35 , 41 , 44 ]. Confirmatory diagnosis of dengue was performed by laboratory tests, such as serology for anti-dengue IgM and/or IgG (12/15, 80.0%) [ 31 – 35 , 37 , 38 , 41 – 45 ] dengue nonstructural protein 1 (NS1) antigen test (3/15, 20.0%) [ 35 , 36 , 45 ], identification of viral ribonucleic acid (RNA) using polymerase chain reaction (PCR) (4/15, 26.7%) [ 34 , 35 , 38 , 40 ], and isolation of viruses (1/15, 6.7%) [ 38 ].…”

“…Other five studies did not specify the criteria for obesity [ 31 , 33 , 35 , 41 , 44 ]. Confirmatory diagnosis of dengue was performed by laboratory tests, such as serology for anti-dengue IgM and/or IgG (12/15, 80.0%) [ 31 – 35 , 37 , 38 , 41 – 45 ] dengue nonstructural protein 1 (NS1) antigen test (3/15, 20.0%) [ 35 , 36 , 45 ], identification of viral ribonucleic acid (RNA) using polymerase chain reaction (PCR) (4/15, 26.7%) [ 34 , 35 , 38 , 40 ], and isolation of viruses (1/15, 6.7%) [ 38 ]. The majority of studies employed multiple diagnostic assays to confirm the diagnosis of dengue, except for one study that did not specify the method used [ 39 ].…”

“…The majority of studies employed multiple diagnostic assays to confirm the diagnosis of dengue, except for one study that did not specify the method used [ 39 ]. Warning signs or symptoms were reported as follows: skin bleeding (petechiae, purpura, hematoma) (9/15, 60.0%) [ 31 – 33 , 35 , 37 , 38 , 41 , 42 , 44 ], epistaxis (4/15, 26.7%) [ 31 – 33 , 41 ], hematemesis (3/15, 20.0%) [ 31 – 33 ], melena (3/15, 20.0%) [ 31 – 33 ], hepatomegaly (7/15, 46.7%) [ 33 , 34 , 37 , 38 , 41 , 42 , 44 ], abdominal pain (8/15, 53.4%) [ 33 – 38 , 41 , 42 ], vomiting and nausea (8/15, 53.4%) [ 33 – 38 , 41 , 42 ], diarrhea (4/15, 26.7%) [ 33 , 36 , 42 , 44 ], thrombocytopenia (4/15, 26.7%) [ 33 , 36 , 37 , 44 ], seizure (1/15, 6.7%) [ 33 ], bleeding gums (1/15, 6.7%) [ 32 ], pleural effusion (3/15, 20.0%) [ 33 , 42 , 44 ], ascites (1/15, 6.7%) [ 42 ], menorrhagia (1/15, 6.7%) [ 32 ] shock (1/15, 6.7%) [ 33 ], hemoconcentration (1/15, 6.7%) [ 33 ] and altered consciousness (1/15, 6.7%) [ 33 ].…”