A STUDY OF MULTIORGAN DYSFUNCTION IN PATIENTS WITH DENGUE AND ITS CLINICO- HAEMATOLOGICAL CORRELATION WITH SEVERITY.

Objective: To study of multiorgan dysfunction in patients with dengue and to correlate the severity and clinical outcome with different haematological parameters.Material & methods: All suspected cases of dengue admitted to Medicine dept within 1 year period were evaluated & classified as DF(dengue fever), DHF(dengue hemorrhagic fever), DSS(dengue shock syndrome).Results: out of total 150 cases,108 cases were classified as DF, 31 cases as DHF and 11 cases as DSS. Liver involvement was seen in 97.33% cases. Jaundice was observed in 10 cases(6.6%),abnormal AST(aspartate transaminase) in 146 (97.33 %) cases and abnormal ALT(alanine transaminase)in 126 (84%) cases. Bleeding manifestations was reported in 61 patients (40.6%).Presence of GI Bleeding in 17 patients (11.3%) was related to severe disease. Thrombocytopenia was present in 25% of DF cases, and in all cases of DHF and DS. Among these, PT(prothrombin time) was prolonged in 10 cases and aPTT(activated partial thromboplastin time) in 47 patients. Serum Fibrinogen was low in 28.57 % of patients. Multiorgan dysfunction was observed in the form of simultaneous hepatic and renal dysfunction in 3.33 % of cases, hepatic and CNS dysfunction in 2.66% of cases, hepatic & cardiac dysfunction in 2% of cases and all the organ system dysfunction in 0.67% of cases.Conclusion: The extent of rise of liver enzymes, PT, aPTT & fall of serum fibrinogen, and degree of thrombocytopenia correlated with disease severity. Acute renal failure, encephalitis and myocarditis are manifestations of severe form of dengue. Major organ involvement may occur in simple DF also