Correlation of Hepatic Transaminases and thrombocytopenia with severity of Dengue infection in Tertiary Care Hospital, Eluru

Dr. N L Narasimha Rao; Dr. K. Vishnuvardhan Rao; Dr Ch. Kishore Kumar

Volume : IX, Issue : VI, June - 2019

Correlation of Hepatic Transaminases and thrombocytopenia with severity of Dengue infection in Tertiary Care Hospital, Eluru

Dr. N L Narasimha Rao, Dr. K. Vishnuvardhan Rao, Dr Ch. Kishore Kumar

Abstract :

Background: Dengue virus infection is a major and important public health problem in many South East Asian countries¹ and also in more than 100 countries of tropical and subtropical region.2Two–fifths of the world’s population or 2500 million people are now at risk for dengue, and every year approximately 50 million new cases occur worldwide Dengue is the most common arboviral disease transmitted globally, is caused by four anti genetically distinct dengue virus serotypes (DEN 1, DEN 2, DEN 3 and DEN 4).4Recently an increasing trend of outeaks of dengue infections and its severe forms have been reported in India.4, Objectives: 1. To study hepatic enzymes status and thrombocytopenia in patients with dengue infection 2. To correlate hepatic enzymes , thrombocytopenia with severity of dengue fever MATERIALS AND METHODS Study design: prospective study Methodology: the present study was conducted in department of pediatrics ASRAM medical college during study period from October 2016 to August 2018 Enrollment of cases: All clinically suspected cases of dengue infection aged between 2 months to 18 years 50 pediatric cases of dengue WHO satisfied inclusion criteria were included during the study period RESULTS: Mean age was 8.62+4.30 years, ranging from 1 to 18 years. 62% were male children and 38% were female children. Most of the male children (45.2%) were in 11–15 years age group. Most of the female children (63.2%) were in 6– 10 years age group.  These 50 cases were grouped into probable dengue, dengue with warning signs and severe dengue as per the W.H.O guidelines.  Hepatomegaly was seen in 4.31% cases of probable dengue, 39.1% of dengue without warning signs and 75.0% of severe dengue cases.  Elevated SGOT levels were observed in 78.3% dengue cases, 82.6% in dengue with warning signs cases and all severe dengue cases. This shows that as severity of dengue increases, SGOT levels increases  Elevated SGPT levels were observed in 39.1% probable dengue cases, 60.9% dengue with warning signs cases and all severe dengue cases. This shows that as severity of dengue increases, SGPT levels increases.  It was found that elevated liver enzymes were seen more frequently in severe dengue followed by dengue with warning signs and probable dengue patients.  It was found that thrombocytopenia was present in 100% of severe dengue, 87% on dengue with warning signs, 52.2% of dengue without warning signs.  As the severity of dengue infection increases, the platelet counts decreases  Mean platelet counts were decreasing as severity of dengue is increasing. The difference was found statistically significant  Mean SGOT, SGPT levels were increasing as severity of dengue infection is increasing. This difference was found statistically significant. CONCLUSION: In dengue infections the degree of liver dysfunction varies from mild injury with elevation of transaminase levels, hepatomegaly to severe injury with jaundice and fulminate hepatic failure. In the present study, elevated SGOT levels were observed in 82.0% cases, elevated SGPT levels were observed in 54.0% cases, and also there is a significant raise in the levels of both the enzymes as the severity of dengue infection increases. As the severity of dengue increases the platelet count decreases. No significant correlation was observed between elevation of hepatic transaminases and thrombocytopenia as the severity of dengue illness increases.