Gastrointestinal and hepatic manifestations and outcome in dengue multi-organ dysfunction syndrome: data from a tertiary referral center
OBJECTIVE: Dengue is a major international public health problem and is endemic in many parts of India. Multiorgan dysfunction is associated with poor outcomes in severe dengue patients. In addition, hepatic and gastrointestinal (GI) involvement are common in dengue. We aimed to study various GI and...
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| Format: | Article |
| Language: | English |
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Verduci Editore
2023-09-01
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| Series: | Infectious Diseases and Tropical Medicine |
| Subjects: | |
| Online Access: | https://www.infectiousjournal.com/wp-content/uploads/sites/6/2023/09/Art.-28159.pdf |
| _version_ | 1797368554243227648 |
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| author | A. Vaidya S. Pankaj Salvi |
| author_facet | A. Vaidya S. Pankaj Salvi |
| author_sort | A. Vaidya |
| collection | DOAJ |
| description | OBJECTIVE: Dengue is a major international public health problem and is endemic in many parts of India. Multiorgan dysfunction is associated with poor outcomes in severe dengue patients. In addition, hepatic and gastrointestinal (GI) involvement are common in dengue. We aimed to study various GI and hepatic manifestations and their outcome in dengue MODS.
PATIENTS AND METHODS: We performed a cross-sectional observational study on patients in our medicine department. Dengue with multi-organ dysfunction syndrome (MODS) patients based on SOFA score were included. Patients with pre-existing chronic liver disease, chronic kidney disease and coagulation disorders were excluded.
RESULTS: Overall, 69 patients were included in the study. Males were 37 (53.6%). The mean age was 38.7 (±18.73) years. Regarding clinical presentation, anorexia was seen in 58% of patients, abdominal pain and vomiting in 55.1%, gastrointestinal (GI) bleeding in 36.1%, diarrhoea in 21.7%, jaundice in 26.1%, abdominal distension in 5.8% and hepatic encephalopathy in 4.3%. There was no significant correlation between platelet count and GI bleeding and outcome. On LFT examination, abnormal ALT, AST and ALP levels were noted in 68.7%, 88.1%, and 44.8% of patients. Hypoalbuminemia and coagulopathy were seen in 64.2% and 16.4%, respectively. Serum albumin level significantly correlated with outcome. Cholestasis was present in 11 patients, of which nine died. Abdominal ultrasound showed pseudo gallbladder edema in 55.8%, mild ascites in 58.8%, and acalculous cholecystitis in 11.8% of patients.
CONCLUSIONS: Anorexia, abdominal pain, vomiting, GI bleeding, and jaundice are common GI and hepatic symptoms. Hypoalbuminemia and cholestasis are predictors of poor outcomes. |
| first_indexed | 2024-03-08T17:34:08Z |
| format | Article |
| id | doaj.art-e0331cc0561743af98f32099cb409d9d |
| institution | Directory Open Access Journal |
| issn | 2379-4054 |
| language | English |
| last_indexed | 2024-03-08T17:34:08Z |
| publishDate | 2023-09-01 |
| publisher | Verduci Editore |
| record_format | Article |
| series | Infectious Diseases and Tropical Medicine |
| spelling | doaj.art-e0331cc0561743af98f32099cb409d9d2024-01-02T13:27:41ZengVerduci EditoreInfectious Diseases and Tropical Medicine2379-40542023-09-01910.32113/idtm_20239_11811181Gastrointestinal and hepatic manifestations and outcome in dengue multi-organ dysfunction syndrome: data from a tertiary referral centerA. Vaidya0S. Pankaj Salvi1Department of Gastroenterology, Seth GS Medical College, Parel Mumbai, Maharashtra, IndiaDepartment of Medicine, BJ Government Medical College and Sassoon General Hospital, Pune, Maharashtra, IndiaOBJECTIVE: Dengue is a major international public health problem and is endemic in many parts of India. Multiorgan dysfunction is associated with poor outcomes in severe dengue patients. In addition, hepatic and gastrointestinal (GI) involvement are common in dengue. We aimed to study various GI and hepatic manifestations and their outcome in dengue MODS. PATIENTS AND METHODS: We performed a cross-sectional observational study on patients in our medicine department. Dengue with multi-organ dysfunction syndrome (MODS) patients based on SOFA score were included. Patients with pre-existing chronic liver disease, chronic kidney disease and coagulation disorders were excluded. RESULTS: Overall, 69 patients were included in the study. Males were 37 (53.6%). The mean age was 38.7 (±18.73) years. Regarding clinical presentation, anorexia was seen in 58% of patients, abdominal pain and vomiting in 55.1%, gastrointestinal (GI) bleeding in 36.1%, diarrhoea in 21.7%, jaundice in 26.1%, abdominal distension in 5.8% and hepatic encephalopathy in 4.3%. There was no significant correlation between platelet count and GI bleeding and outcome. On LFT examination, abnormal ALT, AST and ALP levels were noted in 68.7%, 88.1%, and 44.8% of patients. Hypoalbuminemia and coagulopathy were seen in 64.2% and 16.4%, respectively. Serum albumin level significantly correlated with outcome. Cholestasis was present in 11 patients, of which nine died. Abdominal ultrasound showed pseudo gallbladder edema in 55.8%, mild ascites in 58.8%, and acalculous cholecystitis in 11.8% of patients. CONCLUSIONS: Anorexia, abdominal pain, vomiting, GI bleeding, and jaundice are common GI and hepatic symptoms. Hypoalbuminemia and cholestasis are predictors of poor outcomes.https://www.infectiousjournal.com/wp-content/uploads/sites/6/2023/09/Art.-28159.pdfdenguemodshepaticgastrointestinalhypoalbuminemiacholestasis |
| spellingShingle | A. Vaidya S. Pankaj Salvi Gastrointestinal and hepatic manifestations and outcome in dengue multi-organ dysfunction syndrome: data from a tertiary referral center Infectious Diseases and Tropical Medicine dengue mods hepatic gastrointestinal hypoalbuminemia cholestasis |
| title | Gastrointestinal and hepatic manifestations and outcome in dengue multi-organ dysfunction syndrome: data from a tertiary referral center |
| title_full | Gastrointestinal and hepatic manifestations and outcome in dengue multi-organ dysfunction syndrome: data from a tertiary referral center |
| title_fullStr | Gastrointestinal and hepatic manifestations and outcome in dengue multi-organ dysfunction syndrome: data from a tertiary referral center |
| title_full_unstemmed | Gastrointestinal and hepatic manifestations and outcome in dengue multi-organ dysfunction syndrome: data from a tertiary referral center |
| title_short | Gastrointestinal and hepatic manifestations and outcome in dengue multi-organ dysfunction syndrome: data from a tertiary referral center |
| title_sort | gastrointestinal and hepatic manifestations and outcome in dengue multi organ dysfunction syndrome data from a tertiary referral center |
| topic | dengue mods hepatic gastrointestinal hypoalbuminemia cholestasis |
| url | https://www.infectiousjournal.com/wp-content/uploads/sites/6/2023/09/Art.-28159.pdf |
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