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Predicting acute liver failure in dengue infection

Authors:

R S Kumarasena,

University Medical Unit, Colombo North Teaching Hospital, Ragama, LK
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M A Niriella ,

Faculty of Medicine, University of Kelaniya, Ragama, LK
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C K Ranawaka,

University Medical Unit, Colombo North Teaching Hospital, Ragama, LK
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J K N D Miththinda,

University Medical Unit, Colombo North Teaching Hospital, Ragama, LK
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A P De Silva,

Faculty of Medicine, University of Kelaniya, Ragama, LK
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A S Dassanayaka,

Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka, LK
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H J de Silva

Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka, LK
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Abstract

In a retrospective study involving 240 patients with dengue infection, we attempted to identify early predictors of acute liver failure (ALF). Sixteen out of 41 patients with serum AST more than 1000 IU/ml developed ALF compared to none with serum AST less than 1000 IU/ml. Among patients with serum AST more than 1000 IU/ml, presence of two of the three following phenomena, within the first 5 days of illness: elevated serum bilirubin, elevated alkaline phosphatise or persistent nausea and vomiting, predicted development of ALF (93.8% sensitivity, 98.7% specificity, 83.3% positive predictive and 99% negative predictive value). The presence of elevated serum bilirubin, alkaline phosphatase and persistent nausea and vomiting in patients with very high serum AST during the early phase of dengue infection should alert the physician of impending ALF.

DOI: https://doi.org/10.4038/cmj.v61i1.8260
How to Cite: Kumarasena, R.S., Niriella, M.A., Ranawaka, C.K., Miththinda, J.K.N.D., De Silva, A.P., Dassanayaka, A.S. and de Silva, H.J., 2016. Predicting acute liver failure in dengue infection. Ceylon Medical Journal, 61(1), pp.35–36. DOI: http://doi.org/10.4038/cmj.v61i1.8260
Published on 21 Mar 2016.
Peer Reviewed

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