Title : Transaminitis among patients with dengue fever visiting a tertiary care centre
Abstract:
Introduction: Transaminitis is the condition where serum aspartate transaminase and alanine transaminase increase indicating the liver dysfunction. One such disease where liver involvement might be observed is dengue, which is mosquito-borne viral infection. The aim of the study was to find out the prevalence of transaminitis among patients with dengue fever in a tertiary care centre.
Methods: A descriptive cross-sectional study was conducted in a tertiary care center of Kathmandu from 1st November 2022 to 31st March 2023 after obtaining ethical clearance from the institutional review committee. Patients diagnosed with dengue were enrolled in the study after their informed written consent. Convenience sampling was used to collect the data. A rapid immunochromatography test was used to confirm dengue infection. Serum aspartate transaminase and alanine transaminase were measured through routine Reitman and Frankel’s enzymatic method. Dengue confirmed patients from medical outpatient department, fever clinic, and medical ward of the centre were included in the study. Patients with known prior liver diseases or any other chronic diseases, pregnancy, and patients in the hospice unit were excluded. The point estimate was calculated at a 95% Confidence Interval.
Results: Among 442 dengue infected, the prevalence of transaminitis was 188 (42.53%) (37.92-47.13, 95% Confidence Interval). Increased serum AST was observed in 233 (52.71%) and ALT was seen in 204 (46.15%). The highest frequency of dengue positive was observed among the 18-35 years age group, which was 97 (51.59%) with male predominance 134 (71.27%). Among transaminitis patients, 71 (37.76%) and 54 (28.72%) complained symptoms of nausea and vomiting, respectively. Decreased platelets count was seen among 151 (80.31%) while increased creatinine was seen in 27 (14.36%).
Conclusions: The finding of present study suggests that transaminitis prevalence is common in dengue infection, which is slightly lower than other studies.
Keywords: alanine transaminase; aspartate transaminase; dengue.
Audience Take Away:
- This study showed that liver injury is a very common complication of dengue fever, as reflected by the high prevalence of transaminitis. This study also observed low platelets and azotemia in dengue infection.
- These complications may lead to further life-threatening conditions, like acute liver failure, minor bleeding like petechia or purpura as a life-threatening central nervous system bleed or gastrointestinal bleed, pre-renal acute kidney injury, etc.
- So while treating a dengue patient, regular monitoring of the liver function test, kidney function test, and platelet count is mandatory so that we can detect the complication at the earliest possible time and intervene and prevent the fetal complication in a patient with dengue fever.
- This study found that transaminitis is prevalent among dengue-infected individuals. This opens the door for future analytical studies to correlate the severity of infection and associated complications with the severity of transaminitis.
