International Poster Session(JDDW)
November 4 (Fri.), 15:04–15:44, Room 16 (Kobe International Exhibition Hall No. 2 Building Hall (North) Digital Poster Session)
IP-60_H

ASSESSMENT OF SEVERITY OF ACUTE LIVER INJURY IN PATIENTS WITH DENGUE FEVER IN LAHORE AND RAWALPINDI.

T. Khurshid1
Co-authors: S. Shakeel2, M. Umar1, B. Khar1, A. Subhan3, M. Saleih4, E. Shahid5, M. Usman5, A. Gondal5, A. Shahzad1, F. Tahir1, Z. Butt1, S. Sajjad4, J. Khan6, M. Irfan7
1
Holy Family Hospital Medical Unit 1 Rawalpindi
2
Lahore General Hospital
3
Agha Khan University Hospital
4
Shifa International Hospital
5
Jinnah Hospital Lahore
6
Holy Family Hospital
7
Holy Family Hospital Rawalpindi
BACKGROUND:
OBJECTIVE:

To evaluate the impact of Dengue Virus on liver by measuring patient's aminotransferases during epidemics in Lahore (2011) and Rawalpindi (2015).
METHODOLOGY:
Multi-centered retrospective analysis of 1700 patients (1000-LGH and 700-BBH in 2011 & 2015 respectively. Data was analyzed in SPSS 19 with 16 variables.
Degree of Liver Damage
Degree of liver damage was evaluated and classified into four groups according to AST and ALT levels. Laboratory reference values (AST for males: females 28 & 26 IU) (ALT for males: females 30 & 29 IU) respectively at presentation.
Group A: Normal AST and ALT.
Group B: One of aminotransferases increased < UNL X 3.
Group C: Transaminitis of 3-10 X reference values.
Group D: Transaminitis >10 X reference values.
RESULTS:
Patients were classified into classical DF, DHF and DSS (77.6%, 20.6% and 1.8% respectively. The degree of rise in aminotransferases (liver injury) observed in LGH and BBH were 34.9% vs 43.8% (Grade A), 48.5% vs 49.3% (Grade B), 14.8% vs 6.6% (Grade C) and 1.8% vs 0.3% (Grade D) respectively.
In classic DF, (5% vs 2.8%) were having grade C & D liver damage and (95% vs 97.2%) have no significant liver injury in LGH and BBH respectively. In DHF, aminotransferases were high in (83.2% vs 68.6%) of which (71.3% vs 54.8% have Grade C and (31.8% vs 17.3%) have Grade D Liver injury.
In patients with DSS, (10% vs 3.1%) have Grade C and 90% vs 83.2%) with Grade D (Highest mortality and morbidity) in LGH and BBH respectively.
CONCLUSIONS:
In Dengue outbreaks in Lahore (2011) and Rawalpindi (2015), majority of patients had DF with a rise in liver enzymes.
A significant rise of liver enzymes (Grade D) was observed in patients with DHF and DSS indicative of severity of epidemics.
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