A comparison of the pattern of liver involvement in dengue hemorrhagic fever with classic dengue fever

S Fadilah S. Abdul Wahid, Sahrir Sanusi, Mazlam Mohd Zawawi, Raymond Azman Ali

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Abstract

The impact of dengue on liver function was studied on fifty serologically confirmed dengue cases admitted to Hospital Universiti Kebangsaan Malaysia (HUKM). Twenty-five of these patients had classic dengue fever (DF) and 25 had grade 1 or 2 dengue hemorrhagic fever (DHF). There were more (60%) DHF patients with hepatomegaly compared to DF (40%) but the difference was not statistically significant. Analysis of the liver profile showed that liver dysfunction was commoner in DHF compared to DF, indicating that the degree of liver impairment may be related to the severity of DHF. Hyperbilirubinemia was noted in 3 (12%) DHF and 2 (8%) DF patients. The mean (range) serum bilirubin was higher in DHF [14.2(5-50) μmol/1] compared to DF [10.9(5-30) μmol/1)] (p > 0.05). Elevated levels of serum alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were observed more frequently in DHF (20 and 12 patients respectively) compared to DF (16 and 8 patients respectively). Nine (36%) DHF and 6 (24%) DF patients had concomitant elevation of ALT and ALP levels. The mean (range) serum ALT levels were 109.3(23-325) U/1 in DHF and 90.8(13-352) U/1 in DF (p > 0.05). The mean (range) serum ALP levels were 102.2(15-319) U/1 in DHF and 93.3(34-258) U/1 in DF (p > 0.05). The ALT and ALP levels were significantly higher in DHF patients with spontaneous bleeding than those without bleeding (p < 0.05) None of the patients developed fulminant hepatitis. The immunoregulatory cells, which include the T (CD3), B (CD 19), CD4, CD8, CD5 and natural killer (NK) cells were significantly lower in DHF compared to DF patients (p < 0.05). However, the reduction in these cell counts did not correlate with the liver dysfunction seen in DHF patients. In conclusion, hepatomegaly and liver dysfunction were commoner in DHF compared to DF.

Original languageEnglish
Pages (from-to)259-263
Number of pages5
JournalSoutheast Asian Journal of Tropical Medicine and Public Health
Volume31
Issue number2
Publication statusPublished - Jun 2000

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Severe Dengue
Dengue
Liver
Alanine Transaminase
Alkaline Phosphatase
Liver Diseases
Hepatomegaly
Serum
Hemorrhage
Hyperbilirubinemia
Malaysia
Bilirubin
Natural Killer Cells

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{c2d78b03969340aa879027e472c70bd8,
title = "A comparison of the pattern of liver involvement in dengue hemorrhagic fever with classic dengue fever",
abstract = "The impact of dengue on liver function was studied on fifty serologically confirmed dengue cases admitted to Hospital Universiti Kebangsaan Malaysia (HUKM). Twenty-five of these patients had classic dengue fever (DF) and 25 had grade 1 or 2 dengue hemorrhagic fever (DHF). There were more (60{\%}) DHF patients with hepatomegaly compared to DF (40{\%}) but the difference was not statistically significant. Analysis of the liver profile showed that liver dysfunction was commoner in DHF compared to DF, indicating that the degree of liver impairment may be related to the severity of DHF. Hyperbilirubinemia was noted in 3 (12{\%}) DHF and 2 (8{\%}) DF patients. The mean (range) serum bilirubin was higher in DHF [14.2(5-50) μmol/1] compared to DF [10.9(5-30) μmol/1)] (p > 0.05). Elevated levels of serum alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were observed more frequently in DHF (20 and 12 patients respectively) compared to DF (16 and 8 patients respectively). Nine (36{\%}) DHF and 6 (24{\%}) DF patients had concomitant elevation of ALT and ALP levels. The mean (range) serum ALT levels were 109.3(23-325) U/1 in DHF and 90.8(13-352) U/1 in DF (p > 0.05). The mean (range) serum ALP levels were 102.2(15-319) U/1 in DHF and 93.3(34-258) U/1 in DF (p > 0.05). The ALT and ALP levels were significantly higher in DHF patients with spontaneous bleeding than those without bleeding (p < 0.05) None of the patients developed fulminant hepatitis. The immunoregulatory cells, which include the T (CD3), B (CD 19), CD4, CD8, CD5 and natural killer (NK) cells were significantly lower in DHF compared to DF patients (p < 0.05). However, the reduction in these cell counts did not correlate with the liver dysfunction seen in DHF patients. In conclusion, hepatomegaly and liver dysfunction were commoner in DHF compared to DF.",
author = "{S. Abdul Wahid}, {S Fadilah} and Sahrir Sanusi and Zawawi, {Mazlam Mohd} and Ali, {Raymond Azman}",
year = "2000",
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T1 - A comparison of the pattern of liver involvement in dengue hemorrhagic fever with classic dengue fever

AU - S. Abdul Wahid, S Fadilah

AU - Sanusi, Sahrir

AU - Zawawi, Mazlam Mohd

AU - Ali, Raymond Azman

PY - 2000/6

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N2 - The impact of dengue on liver function was studied on fifty serologically confirmed dengue cases admitted to Hospital Universiti Kebangsaan Malaysia (HUKM). Twenty-five of these patients had classic dengue fever (DF) and 25 had grade 1 or 2 dengue hemorrhagic fever (DHF). There were more (60%) DHF patients with hepatomegaly compared to DF (40%) but the difference was not statistically significant. Analysis of the liver profile showed that liver dysfunction was commoner in DHF compared to DF, indicating that the degree of liver impairment may be related to the severity of DHF. Hyperbilirubinemia was noted in 3 (12%) DHF and 2 (8%) DF patients. The mean (range) serum bilirubin was higher in DHF [14.2(5-50) μmol/1] compared to DF [10.9(5-30) μmol/1)] (p > 0.05). Elevated levels of serum alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were observed more frequently in DHF (20 and 12 patients respectively) compared to DF (16 and 8 patients respectively). Nine (36%) DHF and 6 (24%) DF patients had concomitant elevation of ALT and ALP levels. The mean (range) serum ALT levels were 109.3(23-325) U/1 in DHF and 90.8(13-352) U/1 in DF (p > 0.05). The mean (range) serum ALP levels were 102.2(15-319) U/1 in DHF and 93.3(34-258) U/1 in DF (p > 0.05). The ALT and ALP levels were significantly higher in DHF patients with spontaneous bleeding than those without bleeding (p < 0.05) None of the patients developed fulminant hepatitis. The immunoregulatory cells, which include the T (CD3), B (CD 19), CD4, CD8, CD5 and natural killer (NK) cells were significantly lower in DHF compared to DF patients (p < 0.05). However, the reduction in these cell counts did not correlate with the liver dysfunction seen in DHF patients. In conclusion, hepatomegaly and liver dysfunction were commoner in DHF compared to DF.

AB - The impact of dengue on liver function was studied on fifty serologically confirmed dengue cases admitted to Hospital Universiti Kebangsaan Malaysia (HUKM). Twenty-five of these patients had classic dengue fever (DF) and 25 had grade 1 or 2 dengue hemorrhagic fever (DHF). There were more (60%) DHF patients with hepatomegaly compared to DF (40%) but the difference was not statistically significant. Analysis of the liver profile showed that liver dysfunction was commoner in DHF compared to DF, indicating that the degree of liver impairment may be related to the severity of DHF. Hyperbilirubinemia was noted in 3 (12%) DHF and 2 (8%) DF patients. The mean (range) serum bilirubin was higher in DHF [14.2(5-50) μmol/1] compared to DF [10.9(5-30) μmol/1)] (p > 0.05). Elevated levels of serum alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were observed more frequently in DHF (20 and 12 patients respectively) compared to DF (16 and 8 patients respectively). Nine (36%) DHF and 6 (24%) DF patients had concomitant elevation of ALT and ALP levels. The mean (range) serum ALT levels were 109.3(23-325) U/1 in DHF and 90.8(13-352) U/1 in DF (p > 0.05). The mean (range) serum ALP levels were 102.2(15-319) U/1 in DHF and 93.3(34-258) U/1 in DF (p > 0.05). The ALT and ALP levels were significantly higher in DHF patients with spontaneous bleeding than those without bleeding (p < 0.05) None of the patients developed fulminant hepatitis. The immunoregulatory cells, which include the T (CD3), B (CD 19), CD4, CD8, CD5 and natural killer (NK) cells were significantly lower in DHF compared to DF patients (p < 0.05). However, the reduction in these cell counts did not correlate with the liver dysfunction seen in DHF patients. In conclusion, hepatomegaly and liver dysfunction were commoner in DHF compared to DF.

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