Prevalence of dengue infection in north Indian children with acute hepatic failure.
Hepatic manifestations of dengue viral infection are well known and cases of acute hepatic failure (AHF) with evidence of dengue infection are reported.


OBJECTIVE
To study the role of dengue infection in AHF presenting to hospital.


METHODS



METHODS
Pediatric wards of a teaching hospital in northern India.


METHODS
Consecutive children hospitalized with AHF over a 3 month period in 2006. Clinical and laboratory details of subjects were charted. ELISA tests for dengue IgM were done in all patients using commercial kits. Real time PCR assays for dengue genome were done in randomly chosen subjects from those testing positive and negative for IgM. A PCR positive case was considered as definite dengue infection, while those who were only IgM positive were considered as 'probable' dengue.


RESULTS
Between July and September 2006, 27 patients were enrolled. Thirteen were unequivocally positive for dengue IgM. A random sample of 7 IgM positive and 3 IgM negative patients was tested by PCR, of which 4 IgM positive and one IgM negative patients were PCR positive. Prevalence of definite dengue infection in AHF was therefore 5/27 or 18.5%. No significant differences were observed in clinical and laboratory features of dengue and nondengue aHF.


CONCLUSIONS
Dengue infection should be considered in the etiology of AHF in this part of the world. Clinico-laboratory differentiating features of dengue AHF should be studied in a larger sample of patients.
Kumar
Rashmi
R
Department of Pediatrics, Chhatrapati Shahuji Maharaj Medical University, Lucknow, India. rashmik2005@gmail.com
Tripathi
Piyush
P
Tripathi
Sanjeev
S
Kanodia
Alok
A
Venkatesh
Vimala
V
D002675:Child, Preschool; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007194:India / Q000453:epidemiology; D007223:Infant; D017114:Liver Failure, Acute / Q000453:epidemiology* / Q000821:virology*; D008297:Male; D015995:Prevalence; D016036:Seroepidemiologic Studies; D019595:Severe Dengue / Q000453:epidemiology* / Q000276:immunology
D007075:Immunoglobulin M