Roy Amrita, Sarkar Debalina, Chakraborty Sohini, Chaudhuri Jasodhara, Ghosh Pramit, Chakraborty Swapna
Department of Paediatrics, Medical College and Hospitals, Kolkata, West Bengal, India.
N Am J Med Sci. 2013 Aug;5(8):480-5. doi: 10.4103/1947-2714.117313.
The spectrum of liver dysfunction in children with dengue infection is wide and has been associated with disease severity.
This study was undertaken to estimate the range of hepatic involvement in dengue infection in children.
This study assessed the biochemical and clinical profile of hepatic involvement by dengue virus in 120 children with serologically positive dengue fever (DF), aged 2 months to 14 years.
All cases were grouped into DF without warning signs (Group 1), DF with warning signs (Group 2) and severe dengue (Group 3) according to revised World Health Organization 2009 criteria. The spectrum of hepatic manifestations included hepatomegaly (80.8%), hepatic tenderness (46.3%), jaundice (60%), raised aspartate transaminase (AST), alanine transaminase (ALT) and prolonged prothrombin time (41.7%) and reduced serum albumin (56%).
Hepatic dysfunction was observed more in Groups 2 and 3. There was 84.4% and 93.75% ALT and AST elevation respectively in Group 2 and 94.5% and 95.9% ALT and AST elevation respectively in Group 3 and fulminant hepatic failure was observed in Group 3. Therefore in a child with fever, jaundice, hepatomegaly and altered liver function tests, the diagnosis of dengue infection should be strongly considered in areas where dengue infection is endemic.
登革热感染患儿的肝功能障碍谱广泛,且与疾病严重程度相关。
本研究旨在评估儿童登革热感染时肝脏受累的范围。
本研究评估了120例血清学确诊为登革热(DF)的2个月至14岁儿童的肝脏生化指标和临床特征,这些患儿感染了登革热病毒。
根据世界卫生组织2009年修订标准,所有病例分为无预警体征的登革热(第1组)、有预警体征的登革热(第2组)和重症登革热(第3组)。肝脏表现谱包括肝肿大(80.8%)、肝压痛(46.3%)、黄疸(60%)、天冬氨酸转氨酶(AST)升高、丙氨酸转氨酶(ALT)升高和凝血酶原时间延长(41.7%)以及血清白蛋白降低(56%)。
第2组和第3组中肝功能障碍更为常见。第2组中ALT和AST升高分别为84.4%和93.75%,第3组中ALT和AST升高分别为94.5%和95.9%,第3组观察到暴发性肝衰竭。因此,在登革热感染流行地区,对于出现发热、黄疸、肝肿大及肝功能检查异常的儿童,应高度怀疑登革热感染。