Severity of Acute Hepatitis and Its Outcome in Patients with Dengue Fever in Tertiary Care Hospital Rawalpindi

Usama Zahid; Shazia Nisar; Salman  Saleem; Abdul Rehman  Azeem; Muhammad Arif  Sadiq; Maira  Aleem

doi:10.51253/pafmj.v74i3.12007

Authors

Usama Zahid Department of Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Shazia Nisar Department of Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Salman Saleem Department of Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Abdul Rehman Azeem Department of Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Muhammad Arif Sadiq Department of Hematology, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Maira Aleem Department of Medicine, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i3.12007

Keywords:

Computed tomography severity score, Dengue Fever, Dengue shock syndrome, Hepatitis

Abstract

Objective: To determine the severity and outcome of acute hepatitis in dengue patients.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Pak-Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2022 to Oct 2023.

Methodology: The study included 215 confirmed cases of dengue infection. Data included demographic details day of illness, clinical findings, laboratory parameters, duration of hospital stay, and mortality at the 20th day. Patients experiencing dengue complications such as bleeding and shock were monitored. We divided patients into two groups based on ALT levels: mild to moderate hepatitis with ALT levels up to 299 IU/L and severe hepatitis with ALT levels greater than 300 IU/.

Results: A total of 215 patients with dengue fever were included in this study, out of which 184(83% were male) and 31(14% were female). Out of the total sample size, 181(86%) of patients had dengue fever, 75(33%) had dengue hemorrhagic fever, and 13(6%) had dengue shock syndrome. The study showed statistically significant differences in terms of bleeding in patients with mild/moderate hepatitis (median=109.50) and severe hepatitis (median=55.92), Z=2.52, p=0.012, r=0.174.

Conclusion: This study concluded that severe hepatitis in dengue patients was associated with higher rates of dengue hemorrhagic fever and dengue shock syndrome. Severe hepatitis was also associated with decreased levels of platelets and higher rates of dengue complications like ascites and pleural effusion. It was also associated with a longer hospital stay.

Downloads

Download data is not yet available.

References

Shakoor MT, Ayub S, Ayub Z. Dengue fever: Pakistan’s worst nightmare. WHO South East Asia J Public Health 2012; 1(3): 229–231. https://doi.org/10.4103/2224-3151.207018

Parkash O, Almas A, Wasim Jafri S, Hamid S, Akhtar J, Alishah H. Severity of acute hepatitis and its outcome in patients with dengue fever in a tertiary care hospital Karachi, Pakistan (South Asia). BMC Gastroenterology. 2010; 10: 43.

https://doi.org/10.1186/1471-230x-10-43

Boillat-Blanco N, Klaassen B, Mbarack Z, Samaka J, Mlaganile T, Masimba J, et al. Dengue fever in Dar es Salaam, Tanzania: clinical features and outcome in populations of black and non-black racial category. BMC Infect Dis 2018; 18(1): 3549.

https://doi.org/10.1186%2Fs12879-018-3549-z

Akinsolu FT, de Paiva VN, Souza SS, Varga O.Patent landscape of neglected tropical diseases: an analysis of worldwide patent families. Global Health 2017; 13(1): 82.

https://doi.org/10.1186/s12992-017-0306-9

Butt MU, Mohammad S, Iqbal A. Dengue fever outbreak 2010: Clinical experience in a teaching hospital of Lahore Pakistan. Pak J Med Health Sci 2011; 5: 265-269.

Kaur G, Kumar V, Puri S, Tyagi R, Singh A, Kaur H. Predictors of dengue-related mortality in young adults in a tertiary care centre in North India. J Family Med Prim Care. 2020; 9(2): 694.

https://doi.org/10.4103%2Fjfmpc.jfmpc_605_19

Khan MY, Venkateshwarlu C, Sandeep N, Krishna AH. A Study of Clinical and Laboratory Profile of Dengue Fever in a Tertiary Care Hospital, Nizamabad, Telangana State, India. Int J Contemp Med Res 2016; 3(8)2454-7379.

Morrison AC. Twenty-Seven Years of Field Studies on Dengue and Aedes aegypti in Latin America. InHistory of Arbovirology: Memories from the Field: Volume I: Personal Reflections 2023. Cham: Springer International Publishing.

https://doi.org/10.1155%2F2017%2F8045435

Prajapati R, Mehta R, Kabrawala M, Nandwani S, Patel N, Sethia M, et al. Dengue hepatitis: Incidence, spectrum and outcome. Indian J Gastroenterol 2023 ;42(3): 355-360.

https://doi.org/10.1007/s12664-023-01405-0

Man O, Kraay A, Thomas R, Trostle J, Lee GO, Robbins C, et al. Characterizing dengue transmission in rural areas: A systematic review. PLoS Neglected Trop Dis 2023; 17(6): e0011333.

https://doi.org/10.1371/journal.pntd.0011333

Kalluru PKR, Mamilla M, Valisekka SS, Mandyam S, Calderon Martinez E, Posani S, et al. Aminotransferases in Relation to the Severity of Dengue: A Systematic Review. Cureus 2023; 15(5): e39436. https://doi.org/10.7759/cureus.39436

Khan TA, Nisar S, Qureshi MM, Israr M, Samiullah M. Dengue fever outbreak in twin cities; a tertiary care center experience. Pak Armed Forces Med J 2021; 71(5): 1524–1528.

https://doi.org/10.51253/pafmj.v71i5.4165

Shukla S, Jadhav SM, Gurav YK, Parashar D, Alagarasu K. Serum ferritin level as a prognostic biomarker for predicting dengue disease severity: A systematic review and meta‐analysis. Rev Med Virol 2023: e2468.

https://doi.org/10.1002/rmv.2468

Khan J, Khan I, Ghaffar A, Khalid B. Epidemiological trends and risk factors associated with dengue disease in Pakistan (1980-2014): A systematic literature search and analysis. BMC Public Health 2018 ;18(1): 1–13.

https://doi.org/10.1186%2Fs12889-018-5676-2

Karki B, Salah NH, Srivastava G, Muduli A, Yadav RB. A simulation study for dengue virus detection using surface plasmon resonance sensor heterostructure of silver, barium titanate, and cerium oxide. Plasmonics 2023: 01907-9

http://doi.org/10.1007/s11468-023-01907-9

Nguyen TL, Nguyen TH, Tieu NT. The impact of dengue haemorrhagic fever on liver function. Res Virol 1997; 148(4): 273-277.

https://doi.org/10.1016/s0923-2516(97)88364-1

Qureshi JA, Notta NJ, Salahuddin N, Zaman V, Khan JA. An epidemic of Dengue fever in Karachi--associated clinical manifestations. J Pak Med Assoc 1997; 47(7): 178-181.

Burke DS, Nisalak A, Johnson DE, Scott RM. A prospective study of dengue infections in Bangkok. Am J Trop Med Hygiene 1988 ;38(1): 172-180. https://doi.org/10.4269/ajtmh.1988.38.172

Fujimoto DE, Koifman S. Clinical and laboratory characteristics of patients with dengue hemorrhagic fever manifestations and their transfusion profile. Rev Bras Hematol Hemoter 2014; 36(2): 115–120. https://doi.org/10.5581%2F1516-8484.20140027

Deshwal R, Qureshi MI, Singh R. Clinical and Laboratory Profile of Dengue Fever. J Assoc Physicians India 2015; 63(12): 30-32.https://doi.org/10.37268/mjphm/vol.20/no.2/art.422

Wasay M, Channa R, Jumani M, Zafar A. Changing patterns and outcome of Dengue infection; report from a tertiary care hospital in Pakistan. J Pak Med Assoc 2008; 58(9): 488-489