Clinical and laboratory profile in children with dengue viral infection

Abstract
Background: Dengue infection is the most prevalent arthropod borne viral illness in children associated with liver involvement. In recent studies from India and Thailand, dengue infection was the most important cause of acute hepatic failure in children contributing to 18.5% and 34.3% of the cases respectively. Methods: Hospital based, prospective, observational study in which 120 dengue patients were included in the study. A detailed history and clinical features were recorded on pre-designed proforma. Investigations for dengue and liver function profile were done as per the standard diagnostic work up followed in our hospital. Results: The result of study shows that out of 120 children, 73 (60.8%) have dengue with warning sign, 46 (38.3%) have dengue fever and 1 (0.8%) have severe dengue. Abdominal pain was most commonly seen in the age group of 8-12 year. 20 (16.7%) cases had hepatomegaly and 27% patients had icterus, 83.3% had thrombocytopenia. In our study liver enzyme and severity of dengue fever were significantly associated, although there was no significant association between age group and liver enzyme. The 17.5% cases of dengue viral infection had elevated prothrombin time, and 19.2% had hypo-proteinemia. There was no significant difference between male and female liver profile. Younger age group and complicated dengue viral infection had more abnormal liver profile. Conclusions: Hepatic involvement is more common in severe dengue associated with significant rise of liver enzymes. Hepatomegaly is the most important clinical sign but alteration of liver profile can occur with or without hepatomegaly.