Abstract

Dengue or break bone fever caused by a RNA virus of arbovirus family is spread by Aedes
mosquitoes. It has wide range of presentations ranging from asymptomatic to dengue
hemorrhagic fever with or without shock.In severe conditions it involves heart, liver and
brain with liver as the most common organ involved. Clinical outcome is related to multiple
parameters including high PCV and low platelet count. The frequency of liver involvement
shows variable results with hepatomegaly found in 4 – 52% of cases. The association
between liver injury with PCV and platelet count is not well studied.
Objectives
1. To study the transaminase level in dengue infections as an evidence of hepatic dysfunction.
2. To study the association of liver transaminases with hemodynamic factors like hemoglobin,
packed cell volume, platelet count in dengue patients with liver dysfunction.
Methodology
This is a retrospective cross sectional study conducted using the patient data of the dengue
outbreak in August to October 2017 at Vinayaka Missions Medical College and Hospital,
Karaikal. All dengue patients (n=201) diagnosed with positive dengue Non Structural-1 or
IgM positive were included. After getting institute ethical clearance, AST, ALT, PCV,
Platelet count and baseline data were collected.
Results
Among 201 dengue infected cases, 62% were males and 38% were females. Among them
31% and 45% were having elevation of AST and ALT respectively. Major proportion of
those with elevated liver transaminases were middle aged and among the transaminases
AST was found to be predominantly raised than ALT. Platelet was significantly decreased
in dengue patient with high ALT and high AST compared to that of normal ALT and AST
counterparts. Platelet count showed statistically significant negative correlation with AST
and ALT levels. PCV showed a significant negative correlation with AST levels.
Conclusion
Increase in AST and ALT levels shows the involvement of liver in the dengue patients. A
negative correlation was seen between liver enzymes and platelet levels implying a common
mechanism for both liver injury and low platelet count. Further studies are needed to find
their basis, which may help in early detection of complications and in applying treatment
regimens for dengue patients.