Ishank Goel
Datta Meghe Institute of Medical Sciences, India
Title: Hepatic involvement in Dengue in children- An ominous sign
Biography
Biography: Ishank Goel
Abstract
This cross sectional observational study was done in the paediatric wards and ICU of Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha, Maharashtra, Central India. In our study, children below 16 years with serology positive dengue fever were included. The dengue score formulated in our institute which was pre-designed and pre-validated was used to grade these children according to symptomatology. A score of >20 out of 30 indicated a poor prognosis, 11-19 indicated good prognosis (with some morbidities) and a score of 0-10 indicated excellent prognosis. Outcome was measured in terms of death, ventilatory support, encephalitis, need for transfusion of blood products, shock, prolonged mean duration of stay. In our study, out of the 120 tested patients, 50 children with dengue serology positive were further graded according to their presenting symptoms like tachypnea (4), urine output (4), deranged LFTs (4), hypotension (4), pulse pressure (3), convulsions (3), capillary leak (2), platelet count (2), heart rate (2), fever (1) and rash (1). We found that 42 out of the 50 (84%) had hepatic involvement in the form of deranged LFTs or organomegaly and the remaining 8 had no hepatic involvement. Out of the 42, liver involvement was seen as follows: raised alanine transaminase (ALT) (80.9%), raised aspartate aminotransferase (AST) (71.4%), hepatomegaly (66.7%), reduced serum albumin (59.5%), raised alkaline phosphatase (42.8%) and prolonged prothrombin time (PT) (30.9%). We found that hepatic involvement had a statistically significant association with poor outcome in patients of dengue (along with other markers like tachypnea, urine output and hypotension).