Waheed Ahmad, Shazia Jamil, Riaz Hussain, Nazneen Umar, Fahdel Sheikh.
A Clinical Study to see the Correlation between the Degree of impaired Liver Function Tests (LFT's) and the Complications in Dengue Fever.
Pak J Med Health Sci Jan ;6(2):472-5.

Objectives: To evaluate the correlation between biochemical changes in hepatic function and severity and complications of Dengue Fever on its sufferers. Study design & duration: Observational Prospective study from July 2011 to October 2011 Setting: This study was carried out at Aadil Hospital, DHA, Lahore and Avicenna Hospital, Lahore. Methods: A total of 1459 patients with clinical and serologically confirmed cases of Dengue fever were seen by physician at Aadil and Avicenna Hospital. An Inclusion and Exclusion criteria was developed. The patients who had history of Hepatitis were excluded. The age range was between 14 years to 76 years with no gender discrimination. Chi square test was used to compare categorical variables. Results: 1459 confirmed dengue fever patients were included in this study. 970 were male and 489 female (male to female ratio was approximately 1.98:1). In this study 170(11.65%) patients had no increase in transaminase levels (Grade 0 liver damage), 933(63.94%) patients had mild alteration in Liver enzymes levels (Grade 1 liver damage), 198(13.57%) patients had Grade 2 liver involvement. 133(9.11%) of the patients had progressed to acute hepatitis (Grade 3 liver damage) and 25(1.71%) had severe liver damage (Grade 4 liver damage). Most of the patients 1043(87.05%) had features of dengue fever without complications. In this group the common degree of liver damage (87%) was grade 1. 112 patients presented with dengue hemorrhage and 69 of them 61.69% had grade 2 liver injury. 78 patients presented with dengue shock syndrome. In this group 80.76% patients had grade 3 liver injuries. 42 patients presented with gasterointestinal bleeding, 57.14% had grade 3 liver injury. Conclusion: Mild elevation of the Liver enzymes is a common feature of dengue viral infection. On the other hand, this could be severe to a degree of acute hepatitis or even to fulminant hepatic failure. Severe hepatitis in dengue fever has got worse outcome in terms of hospital stay and complications as compared to mild to moderate hepatitis. There is a high correlation between the degree of liver damage and the appearance of the complications.

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