Serum transaminase levels and dengue shock syndrome in children

Abstract

Background Clinical and biochemical impacts on liver dysfunction, as manifested by an increase in serum transaminase levels, are common in dengue infection. Howevei; an association of elevated serum transaminase and dengue shock syndrome (DSS) has n ot been well-established. Objective To assess for an association between serum transaminase levels and the presence of DSS in children. Methods A nested, case control study was conducted on children aged l month to 12 years admitted to Sanglah Hospital who were diagnosed with dengue infection. Baseline characteristics and serum transaminase levels were recorded. Patients who were included in the study were observed for the presence of DSS. Those who had DSS were selected as cases, and those who did not develop DSS were selected as controls. Data was analyzed using bivariate and multivariate methods with 95% confidence intervals and P value <0.05 was considered as statistically significant. Results Ninety-four children were involeved, 4 7 children in the case group and the other 4 7 were in the control group. Baseline characteristics of the subjects were similar between the case and control groups. Serum aspart ate transaminase (AST) level of 2:: 128 U/L and alanine transaminase (ALT) of 2: 40 U/L were associated with DSS (OR 10; 95%CI 2.3 to 44.4; P=0.002) and (OR 7 .3; 95%CI 1.6 to 32.9; P= 0.009), respectively. Conclusion Elevated AST and ALT levels were associated with an increased risk of DSS in children with dengue infection.

Keywords

• dengue shock syndrome, aspartate transaminase, alanine transaminase