Role of liver indices in differentiating dengue infection from other febrile illness in children

Abstract

Objective: To analyze the liver dysfunction among serologically positive and serologically negative dengue infection comparing them with other febrile illness and controls, in children. Methods: This study was conducted on 304 children between 3 months to 15 years age group, out of which 50 were healthy control group and 254 were admitted with acute febrile illness during an outbreak of dengue infection. Serologically positive dengue, serologically negative dengue, other febrile illness and controls were included in the study. Liver function tests were analyzed and evaluate the hepatic markers for early detection of dengue from other febrile illness. Results: Of the 254 acute febrile patients enrolled in the study, 54 (21.3%) were classified as other febrile illness, 200 (78.7%) were classified as dengue infection. There was a significant difference in total bilirubin, alkaline phosphatase and sodium between other febrile illness and controls with P<0.05. There was a significant elevation of total bilirubin, transaminases, prothrombin time, activated partial thromboplastin time, ammonia with p<0.05 in dengue infection than other febrile illness and controls, but significant decrease in alkaline phosphatase and sodium. C-reactive protein was significantly raised with P<0.05 in the other febrile illness than dengue infection and controls. Conclusion: Raised transaminases, abnormal coagulopathy and hyperammonemia may differentiate the dengue infection from other febrile illness during an acute phase of illness; especially elevated aspartate transaminase and activated partial thromboplastin time were useful as early hepatic markers. C-reactive protein can be used as a marker in conjunction with liver function tests to distinguish dengue infection from other febrile illness.