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Abstract

Background: Dengue fever has become a global and national health concern due to its increasing incidence rate over the past six years. Dengue infection may present with variable sign and symptoms. Major organ involvement may occur, including liver, which is characterized by an elevated transaminase serum level.


Aim: This study aims to identify factors contributing to increased transaminase serum levels in patients with dengue fever at Ngudi Waluyo Wlingi General Hospital between 2023-2024.


Methods: One hundred and sixty-nine patients with positive dengue serology admitted to Ngudi Waluyo Wlingi General Hospital from January 1st, 2023 to May 19th, 2024, were reviewed retrospectively. Only patients aged 15 years and over with complete laboratory data were included in this retrospective cross-sectional study, using total sampling approach. We collected demographic and laboratory data from electronic medical records, then analyzed and correlated the data with liver function values.


Results: Increased AST levels was observed in 70 patients (41.4%), while ALT values was elevated in 32 patients (24.9%). This increase was significantly linked to decreased platelet counts (p=0). Additionally, age was statistically associated with ALT levels (p=0.022), while gender was significantly related to AST levels (p=0.04). However, leukocyte levels and dengue serology showed no significant correlation with serum transaminase levels (p>0.05). Together, dengue serology, platelet counts, leukocyte levels, gender, and age collectively have a significant effect on AST (14.3%) and ALT (13.6%) values. Among these factors, platelet counts exerted the greatest influence on AST and ALT levels.


Conclusion: Elevated transaminase serum levels may occur in patients with dengue fever. This is associated with platelet counts, age, and gender. Therefore, diagnosing dengue infection should prompt measurement of liver function to ensure appropriate management according to each patient’s condition.

Article Details

How to Cite
Wijayanto, F., & Insanitaqwa, A. (2024). Risk Factor Analysis of Elevated Transaminase Serum in Patients with Dengue Fever at Ngudi Waluyo Wlingi General Hospital in 2023-2024. Jurnal Klinik Dan Riset Kesehatan, 3(3), 169-176. https://doi.org/10.11594/jk-risk.03.3.4

References

1. Kementerian Kesehatan Republik Indonesia. Strategi Nasional Penanggulangan Dengue 2021-2025. Kementerian Kesehatan RI; 2021.
2. World Health Organization. Dengue guidelines for diagnosis, treatment, prevention and control : new edition. 2009 [dikutip 2024 Mei 20];(WHO/HTM/NTD/DEN/2009.1). Available from: https://iris.who.int/handle/10665/44188
3. Htun TP, Xiong Z, Pang J. Clinical signs and symptoms associated with WHO severe dengue classification: a systematic review and meta-analysis. Emerg Microbes Infect 2021;10(1):1116–28.
4. Sombat Treeprasertsuk, Chatporn Kittitrakul. Liver Complications in Adult Dengue and Current Management. Southeast Asian J Trop Med Public Health 2015;46 (Supplement 1):99–107.
5. Fernando S, Wijewickrama A, Gomes L, Punchihewa CT, Madusanka SDP, Dissanayake H, dkk. Patterns and causes of liver involvement in acute dengue infection. BMC Infect Dis 2016;16(1):319.
6. Kwo PY, Cohen SM, Lim JK. ACG Clinical Guideline: Evaluation of Abnormal Liver Chemistries. Am J Gastroenterol 2017;112(1):18–35.
7. Dyussenbayev A. Age Periods Of Human Life. Adv Soc Sci Res J [Internet] 2017 [dikutip 2024 Mei 19];4(6). Available from: http://scholarpublishing.org/index.php/ASSRJ/article/view/2924
8. 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(2):164–9.
9. Kementerian Kesehatan Republik Indonesia. KEPUTUSAN MENTERI KESEHATAN REPUBLIK INDONESIA NOMOR HK.01.07/MENKES/9845/2020 TENTANG PEDOMAN NASIONAL PELAYANAN KEDOKTERAN TATA LAKSANA INFEKSI DENGUE PADA DEWASA. 2020;
10. Altaf Ahmed, Sunil N Rao, I.A Khan, Sha Ruknuddin, Zahid Ahmed. Study of co-relation between Transaminitis and fall in platelet counts in patients with Dengue Fever and its association with severity of clinical presentation. Al Am Een J Med Sci 2022;15(3):255–60.
11. Juneja D, Jain R, Nasa P. Dengue induced acute liver failure: A meta summary of case reports. World J Virol [Internet] 2024 [dikutip 2024 Mei 23];13(1). Available from: https://www.wjgnet.com/2220-3249/full/v13/i1/91457.htm
12. Kalas MA, Chavez L, Leon M, Taweesedt PT, Surani S. Abnormal liver enzymes: A review for clinicians. World J Hepatol 2021;13(11):1688–98.
13. Priyangika DKD, Premawansa G, Adikari M, Thillainathan S, Premawansa S, Jayamanne BDW, dkk. Predictive value of hepatic transaminases during febrile phase as a predictor of a severe form of Dengue: analysis of adult Dengue patients from a tertiary care setting of Sri Lanka. BMC Res Notes 2021;14(1):251.
14. Chia PY, Thein TL, Ong SWX, Lye DC, Leo YS. Severe dengue and liver involvement: an overview and review of the literature. Expert Rev Anti Infect Ther 2020;18(3):181–9.
15. Javeria Benyamin, Sidra Anwar, Kamran Rauf. Frequency of Transaminitis in Patient with Dengue Fever in First Five Days of Illness: A Hospital Based Survey. J Pak Soc Intern Med 2024;5(1):441–5.