Revista da Sociedade Brasileira de Medicina Tropical (Dec 2006)
Envolvimento hepático em pacientes com dengue hemorrágico: manifestação rara? Liver involvement in patients with dengue hemorrhagic fever: a rare phenomenon?
Abstract
As manifestações hepáticas são descritas como não usuais no dengue e podem evoluir com quadros graves e potencialmente letais. Avaliamos as alterações hepáticas em 41 pacientes com dengue hemorrágico com confirmação laboratorial (ELISA IgM positivo) em Campo Grande, Mato Grosso do Sul, Brasil e observamos 61% (25/41) de alteração na alanina aminotransferase e 80,5% (33/41) na aspartato aminotransferase, sendo que não houve diferenças estatisticamente significativas quando comparamos as várias formas clínicas. A variação nos valores de ALT foi de 14-547U/l, nos valores da AST foi de 11-298U/l. Náuseas e/ou vômitos foram referidos por 90% (37/41) dos pacientes, 46,3% (19/41) referiram dor abdominal e 10% (3/29) apresentavam hepatomegalia ao exame físico. A idade variou de 18 a 88 anos, 23 (56%) eram mulheres e 18 (44%) homens.Hepatic manifestations are described as unusual complications of dengue and may lead to severe and potentially lethal conditions. Liver abnormalities in 41 patients diagnosed with dengue hemorrhagic fever in Campo Grande, Mato Grosso do Sul, Brazil, between January 1 and March 31, 2002, were evaluated. All were serologically positive for dengue in laboratory tests (IgM ELISA). ALT alterations were observed in 61% (25/41) and AST alterations in 80.5% (33/41), but there were no statistically significant differences between the various clinical forms. The range in ALT levels was 14-547U/l and in AST levels was 11-298U/l. Nausea and/or vomiting were reported by 90% (37/41) of the patients; 46.3% (19/41) had abdominal pain and 10% (3/29) presented hepatomegaly at clinical examination. The patients' ages ranged from 18 to 88 years; 23 (56%) were female and 18 (44%) were male.
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