ACUTE FULMINANT HEPATIC FAILURE IN DENGUE INFECTION: A RARE COMPLICATION

Minal Shastri, Smeet Bhavsar, Nayan Gavli, Darshankumar Raval

Abstract


Dengue fever is a mosquito borne illness caused by Dengue virus. Liver involvement in Dengue is very common and can cause a mild to moderate rise in transaminases but can rarely cause acute fulminant heaptic failure. We present one such case of a 30 year old Hypothyroid, Diabetic and morbidly obese female from Western India who presented with typical manifestations of Dengue fever. Basic laboratory parameters were normal on admission. Initially she responded to treatment but following that she developed acute fulminant hepatic failure and renal failure to which she finally succumbed. This case reveals one of the very rare and fatal complication of Dengue infection in the form of acute fulminant hepatic failure.

Other factors including race, diabetes, haemoglobinopathies, pre-existing liver damage and the use of hepatotoxic drugs may also play a role [188].


Keywords


Dengue, Fulminant Hepatic Failure

Full Text:

PDF

References


Bhatt S, Gething PW, Brady OJ, Messina JP, Farlow AW, Moyes CL, et al. The global International Journal of Community Medicine and Public Health | August 2017 | Vol 4 | Issue 8 Page 3017 distribution and burden of dengue. Nature. 2013;496:504–7.

World Health Organization, Regional Office for South-East Asia. Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever—revised and expanded edition. 2011. www.searo.who.int/entity/vector_borne_tropical_diseases/ documents/SEAROTPS60/en/.

Petedachai W. Hepatic dysfunction in children with dengue shock syndrome. Dengue Bulletin. 2005;29:112-18.

Halstead SB. Dengue Fever and Dengue Haemorrhagic Fever: Behrman R.E., [9] Kliegman R.M, Jenson HB, Bonita F. Stanton. Nelson Textbook of Pediatrics, 18th Edition, Philadelphia: Saunders, 2008.1412-1414

Kuo CH, Tai DI, Chang-Chien CS, Lan CK, Chiou SS, Liaw YF. Liver biochemical [20] tests and dengue fever. Am J Trop Med Hyg. 1992;47:265–70.

, 246

Parkash O, Almas A, Jafri SM, Hamid S, Akhtar J, et al. (2010) Severity of acute hepatitis and its outcome in patients with dengue fever in a tertiary care hospital Karachi, Pakistan (South Asia). BMC Gastroenterol 10: 43.

Souza LJ, Alves JG, Nogueira RM, Gicovate Neto C, Bastos DA, et al. (2004) Aminotransferase changes and acute hepatitis in patients with dengue fever: analysis of 1,585 cases. Braz J Infect Dis 8: 156–163.

Trung DT, Thao le TT, Hien TT, Hung NT, Vinh NN, et al. (2010) Liver involvement associated with dengue infection in adults in Vietnam. Am J Trop Med Hyg 83: 774–780. 5. Wilder-Smith A, Earnest A, Paton NI (2004) Use of simple laboratory features to distinguish the early stage of severe acute respiratory syndrome from dengue fever. Clin Infect Dis 39: 1818–1823.

Kuo CH, Tai DI, Chang-Chien CS, Lan CK, Chiou SS, et al. (1992) Liver biochemical tests and dengue fever. Am J Trop Med Hyg 47: 265–270.

World Health Organization (1997) Dengue Hemorrhagic Fever: Diagnosis, Treatment, Prevention and Control. Geneva, .

World Health Organization Regional Office for Southeast Asia (2011) Comprehensive Guidelines for Prevention and Control of Dengue and Dengue Haemorrhagic Fever.

Kuo CH, Tai DI, Chang-Chien CS, Lan CK, Chiou SS, et al. (1992) Liver biochemical tests and dengue fever. Am J Trop Med Hyg 47: 265–270.

Trung DT, Thao le TT, Hien TT, Hung NT, Vinh NN, et al. (2010) Liver involvement associated with dengue infection in adults in Vietnam. Am J Trop Med Hyg 83: 774–780.

Lum LC, Lam SK, George R, Devi S (1993) Fulminant hepatitis in dengue infection. Southeast Asian J Trop Med Public Health 24: 467–471.

World Health Organization (2009) Dengue: Guidelines for diagnosis, treatment, prevention and control. Geneva.

Brady OJ, Gething PW, Bhatt S, Messina JP, Brownstein JS, Hoen AG et al. Refining the global spatial limits of dengue virus transmission by evidence-based consensus. PLoS Negl Trop Dis. 2012;6:e1760. doi:10.1371/journal.pntd.0001760

Trung DT, Thao le TT, Hien TT, Hung NT, Vinh NN, et al. (2010) Liver involvement associated with dengue infection in adults in Vietnam. Am J Trop Med Hyg 83: 774–780.

Wilder-Smith A, Earnest A, Paton NI (2004) Use of simple laboratory features to distinguish the early stage of severe acute respiratory syndrome from dengue fever. Clin Infect Dis 39: 1818–1823.. Kuo CH, Tai DI, Chang-Chien CS, Lan CK, Chiou SS, et al. (1992) Liver biochemical tests and dengue fever. Am J Trop Med Hyg 47: 265–270.

Lee IK, Liu JW, Yang KD. Fatal dengue hemorrhagic fever in adults: emphasizing the evolutionary pre-fatal clinical and laboratory manifestations. PLoS neglected tropical diseases. 2012;6(2):e1532. pmid:22363829

Low JG, Ong A, Tan LK, Chaterji S, Chow A, Lim WY, et al. The early clinical features of dengue in adults: challenges for early clinical diagnosis. PLoS neglected tropical diseases. 2011;5(5):e1191. pmid:21655307

Parkash O, Almas A, Jafri SM, Hamid S, Akhtar J, Alishah H. Severity of acute hepatitis and its outcome in patients with dengue fever in a tertiary care hospital Karachi, Pakistan (South Asia). BMC Gastroenterol 2010; 10: 43 [PMID: 20459677 DOI: 10.1186/1471-230X-10-43]

Karoli R, Fatima J, Siddiqi Z, Kazmi KI, Sultania AR. Clinical profile of dengue infection at a teaching hospital in North India. J Infect Dev Ctries 2012; 6: 551-554 [PMID: 22842941 DOI: 10.3855/jidc.2010]

Saha AK, Maitra S, Hazra SCh. Spectrum of hepatic dysfunction in 2012 dengue epidemic in Kolkata, West Bengal. Indian J Gastroenterol 2013; 32: 400-403 [PMID: 24037764 DOI: 10.1007/ s12664-013-0382-6]

Trung DT, Thao le TT, Hien TT, Hung NT, Vinh NN, Hien PT, Chinh NT, Simmons C, Wills B. Liver involvement associated with dengue infection in adults in Vietnam. Am J Trop Med Hyg 2010; 83: 774-780 [PMID: 20889864 DOI: 10.4269/ajtmh.2010.10-0090]

Souza LJ, Alves JG, Nogueira RM, Gicovate Neto C, Bastos DA, Siqueira EW, Souto Filho JT, Cezário Tde A, Soares CE, Carneiro Rda C. Aminotransferase changes and acute hepatitis in patients with dengue fever: analysis of 1,585 cases. Braz J Infect Dis 2004; 8: 156-163 [PMID: 15361994 DOI: 10.1590/ S1413-86702004000200006]

Deepak N A, Patel ND. Differential diagnosis of acute liver failure in India. Ann Hepatol 2006; 5: 150-156 [PMID: 17060870]

Tan SS, Bujang MA. The clinical features and outcomes of acute liver failure associated with dengue infection in adults: a case series. Braz J Infect Dis 2013; 17: 164-169 [PMID: 23453417 DOI: 10.1016/j.bjid.2012.09.007]

Tan SS, Bujang MA. The clinical features and outcomes of acute liver failure associated with dengue infection in adults: a case series. Braz J Infect Dis 2013; 17: 164-169 [PMID: 23453417 DOI: 10.1016/j.bjid.2012.09.007]

Giri S, Sharma V, Agarwal M P, Sharma A. Low mortality during 2008 outbreak of dengue in Delhi, India: a clinicobiochemical study. Revista de Ciências Médicas e Biológicas 2010; 9: 10-12 [DOI: 10.13140/2.1.2343.7440]

Senanayake MP, Jayamanne MD, Kankananarachchi I. N-acetylcysteine in children with acute liver failure complicating dengue viral infection. Ceylon Med J 2013; 58: 80-82 [PMID: 23817939 DOI: 10.4038/cmj.v58i2.5684

Penafiel A, Devanand A, Tan HK, Eng P. Use of molecular adsorbent recirculating system in acute liver failure attributable to dengue hemorrhagic fever. J Intensive Care Med 2006; 21: 369-371 [PMID: 17095501 DOI: 10.1177/0885066606293384]

Vinodh BN, Bammigatti C, Kumar A, Mittal V. Dengue fever with acute liver failure. J Postgrad Med 2005; 51:322-3.

Subhash G, et al. Acute hepatic failure due to dengue: A case report. Cases J 2008; 1: 204.

Subramanian V, Shenoy S, Joseph AJ. Dengue haemorrhagic fever and fulminant hepatic failure, Digestive diseases and sciences, 2005 June; 50(6): p1146–7.

Gasperino J, et al. Fulminant liver failure secondary to haemorrhagic dengue in an international traveler. Liver Int. 2007 Oct; (8): 1148–51.


Refbacks

  • There are currently no refbacks.