Utility of Serum Transaminases in Predicting Disease Severity in Dengue Fever- A Cross-sectional Study

Abstract

Introduction: Thrombocytopenia has been known to be a manifestation as well as predictor of severe dengue. However, use of additional biomarkers like Aspartate Aminotransferase (AST)/Alanine Aminotransferase (ALT) alone or in conjunction with platelet count may help in early and better predictability of severe dengue cases. Aim: To determine the correlation between transaminase elevation and severity of dengue fever. Materials and Methods: This was a single centre, cross-sectional study conducted at a tertiary care centre of Western Maharashtra. Total 110 hospitalised patients with a diagnosis of suspected dengue fever, based on clinical signs and symptoms with a positive NS1 antigen test (non structural protein 1)/Immunoglobulin M (IgM) test using rapid test kits were taken as study population. The patients were clinically evaluated on daily basis for development of any warning signs and symptoms along with monitoring of haematological and biochemical parameters. For statistical analysis the technique of percentages, mean and Pearson ‘r’s were employed using IBM Statistical Package for the Social Sciences (SPSS 20.0) version for windows. The p-value of 0.05 was considered as significant value. Results: Out of 110 patients, 83 were males and 27 females. Clinical fluid accumulation was seen in 5 patients (4.5%), bleeding manifestations and fluid accumulation in 4 (3.6%) and bleeding manifestations in 17 (15.5%). Negative correlation was observed between thrombocytopenia with bleeding manifestations (r=-0.17, p=0.04), whereas positive correlation was seen in incidence of bleeding with serositis (r=0.19, p=0.04), AST with serositis (r=0.21, p=0.02) and ALT with Packed Cell Volume (PCV) (r=0.22, p=0.01). Conclusion: Additional biomarkers like AST and ALT alone or in conjunction with platelet count can also help in early prediction of severity of dengue fever.