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Predicting acute liver failure in dengue infection

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dc.contributor.author Ranawaka, C.K.
dc.contributor.author Kumarasena, R.S.
dc.contributor.author Niriella, M.A.
dc.contributor.author Miththinda, J.K.N.D.
dc.contributor.author Pathmeswaran, A.
dc.contributor.author Dassanayake, A.S.
dc.contributor.author de Silva, A.P.
dc.contributor.author de Silva, H.J.
dc.date.accessioned 2016-03-28T06:00:26Z
dc.date.available 2016-03-28T06:00:26Z
dc.date.issued 2012
dc.identifier.citation Sri Lanka Medical Association, 125th International Medical Congress. 2012;57 Suppliment1: 33 en_US
dc.identifier.issn 0009-0895
dc.identifier.uri http://repository.kln.ac.lk/handle/123456789/12369
dc.description Oral Presentation Abstract (OP 38), 125th Anniversary Scientific Medical Congress, Sri Lanka Medical Association, June 2012 Colombo, Sri Lanka en_US
dc.description.abstract INTRODUCTION: Dengue infections (Dl) have a diverse clinical spectrum ranging from asymptomatic illness to severe dengue. Unusual manifestations such as encephalitis, myocarditis, and acute liver failure (ALF) are increasingly recognised. AIMS: To describe the spectrum of liver dysfunction and identify possible predictors of ALF in DI Methods: Serologically confirmed patients with Dl admitted to university medical unit, Ragama from January 2009 to March 2010 were included. Data were obtained from patient records. Results: Out of 240 patients (maleifemale 57.7%:42.5%; mean age 35.6 years[SD 15.4 years]], 49(20.4%) had severe dengue, 164(68.3%) had dengue with warning signs and 27(11.2%) had dengue without warning signs. Abdominal pain, persistent nausea and vomiting (PNV), skin or mucosal bleeding, hepatomegaly and ascites was present in 52.1%J 38.3%, 16.2%, 50% and 11.7% cases respectively. Deranged AST or ALT(ASTALT), serum bilirubin(SB), alkaline phosphatase(ALP), gamma glutamyl transpeptide(GGT), and 1NR were observed in 86.7%, 8.3%, 7.5%, 25% and 10% of patients respectively. Of the 240 patients 41(17.1%) had ASTALT>1000 IU and 199(82.9%) had ASTALT<1000 1U. Only 16/41 patients with ASTALT>1000 IU developed ALF while none from the ASTALT<1000 IU group developed ALF. Presence of 2 or more of elevated SB, elevated ALP or PNV predicted the development of ALF with 93.8% sensitivity, 98.7% specificity, 83.3% positive predictive value and 99% negative predictive value withp<0.001. CONCLUSIONS: ASTALT<1000 IU excluded patients at risk of ALF. Presence of 2 or more of PNV, elevated SB or ALP in patients with Dl may indicate impending ALF. This needs further validation in a larger population. en_US
dc.language.iso en_US en_US
dc.publisher Sri Lanka Medical Association en_US
dc.subject liver failure en_US
dc.title Predicting acute liver failure in dengue infection en_US
dc.type Article en_US


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