Association of Abnormal Coagulation Profile and Liver Enzymes with Dengue Infection and Their Significance as Predictors of Assessing Severity of Disease

INTRODUCTION: One of the most rapidly spreading mosquito-borne viral disease in the world in Dengue. In the last 50 years, incidence has increased 30-fold with increasing geographic expansion to new countries and, in the present decade, from urban to rural settings In 2006, the country witnessed an outbreak of DF/DHF with 12 317 cases and 184 deaths. The incidence of dengue is increasing in the last few years. During 2010, a total of 28 292 cases were reported, which increased to 50 222 in 2012 and 75 808 in 2013 – the highest since 1991. CONTEXT: Dengue is one the leading tropical infections which has a high morbidity and mortality if left untreated, there is a need for recognition of the complications earlier and to treat them accordingly. There are several markers to show the progression of dengue into the critical phase .One among them are aPTT and SGOT, SGPT. AIM OF THE STUDY: To assess the liver enzyme and coagulation profile alterations among dengue patients. To follow up dengue patients over a period of 10 days and asses the progression of disease. To assess correlation between the abnormal lab parameters and their significance as early predictors of fluid leakage and bleeding. SETTINGS AND DESIGN: Prospective study. MATERIALS AND METHODS: The study will be conducted on 100 dengue patients admitted to GRH, Madurai during the study period of 12 months. A previously designed proforma was used to collect the demographic and clinical details of the patients. All the patients underwent detailed clinical evaluation, appropriate investigations. History was taken on details and duration of fever from a dengue endemic H/o headache, joint pain, nause was noted. Platelet count, prothrombin time and INR, liver function tests including serum bilirubin, serum transaminases, serum albumin was estimated Platelet count, liver function tests including serum bilirubin, albumin, globulin, transaminases, prothrombin time activated partial thromboplastin time and INR. STATISTICAL ANALYSIS: One way ANOVA, Pearson correlation and Chi square test. RESULTS: Aptt and INR elevation was found to be significantly elevated among dengue haemorrhagic fever patients. Which served to be a good predictor in the progression of dengue to dengue haemorrhagic fever and preventing the fatel complications. CONCLUSIONS: SGOT and SGPT elevation proved to be an early predictor in the progression of Dengue fever to Dengue Haemorrhagic fever aPTT prolongation proved to be an even early predictor in the progression of Dengue to Dengue haemorrhagic fever and hence rapid intervention prevented the dreaded complications of dengue