DENGUE FEVER;

Abstract

Introduction: Dengue can indicate a diverse clinical spectrum. The intensity ofhepatic involvement in patients, with dengue infection varies from soft injury to severe injury bymeans of jaundice and liver cell failure. Even if liver is not a most important objective limb, liverinvolvement is a renowned aspect. Objectives: The objective of this study was to assess liverinvolvement in dengue patients upto 12 years of age. Study Design: The study was Prospectiveobservational. Place and Duration of Study: Study was conducted in children ward, PaediatricDepartment, Holy Family Hospital Rawalpindi from August 2014 to October 2015. Methods:Upto 12 years of age, all suspected dengue children patients were screened and solitaryserologically established cases by dengue IgM capture ELISA were incorporated in the studyafter taking written permission from the parents of the patients. Patients were categorizedaccording to GCP dengue guidelines into dengue fever (DF), dengue hemorrhagic fever (DHF)and dengue shock syndrome (DSS). Results: Among 146 children, 78 were in the group of DF,35 were in the group of DHF and 33 were in the group of DSS. Most children (70 %) were above5 years. Fever was the leading illness followed by body aches, hepatomegly, rashes, edema,headache, petechiae, hepatic tenderness, pain in abdomen, vomiting, mucosal bleed andjaundice. Children with DSS have more liver involvement. Hepatomegaly and thickening of gallbladder was maximum in children with DSS and can be an indication of severe illness. Serumbilirubin, serum albumin, liver enzymes like ALT, AST and ALP were considerably elevated inchildren with DSS as compare to other two groups. 32 patients out of 33 with DSS had liverinvolvement. Conclusion: Dengue fever has become a main health issues at the moment inPakistan. Hepatic association in dengue in children has high fatality rate and spectrum variesfrom jaundice to rise of liver enzymes.