title: Clinical and hepatic evaluation in adult dengue patients: a prospective two-month cohort study.
abstract: BACKGROUND
  To analyze the liver dysfunction and evolution of signs and symptoms in adult dengue patients during a two-month follow-up period.
  
  
  METHODS
  A prospective cohort study was conducted in Campos dos Goytacazes, Rio de Janeiro, Brazil, from January to July, 2008. The evolution of laboratory and clinical manifestations of 90 adult dengue patients was evaluated in five scheduled visits within a two-month follow-up period. Twenty controls were enrolled for the analysis of liver function. Patients with hepatitis B, hepatitis C, those known to be human immunodeficiency virus (HIV) seropositive and pregnant women were excluded from the study.
  
  
  RESULTS
  At the end of the second month following diagnosis, we observed that symptoms persisted in 33.3% (30/90) of dengue patients. We also observed that, 57.7% (15/26) of the symptoms persisted at the end of the second month. The most persistent symptoms were arthralgia, fatigue, weakness, adynamia, anorexia, taste alteration, and hair loss. Prior dengue virus (DENV) infection did not predispose patients to a longer duration of symptoms. Among hepatic functions, transaminases had the most remarkable elevation and in some cases remained elevated up to the second month after the disease onset. Alanine aminotransferase (ALT) levels overcame aspartate aminotransferase (AST) during the convalescent period. Male patients were more severely affected than females.
  
  
  CONCLUSIONS
  Dengue fever may present a wide number of symptoms and elevated liver transaminases at the end of the second month.
authors.affiliation: Departamento de Clínica Médica, Escola Superior de Ciências, Vitória, ES. ricardotsa@hotmail.com
authors.forename: Ricardo
authors.initials: R
authors.lastname: Tristão-Sá
authors.forename: Claire Fernandes
authors.initials: CF
authors.lastname: Kubelka
authors.forename: Eliana
authors.initials: E
authors.lastname: Zandonade
authors.forename: Sônia Maria Oliveira
authors.initials: SM
authors.lastname: Zagne
authors.forename: Natally de Souza Maciel
authors.initials: Nde S
authors.lastname: Rocha
authors.forename: Luiza Oliveira
authors.initials: LO
authors.lastname: Zagne
authors.forename: Nathália Félix
authors.initials: NF
authors.lastname: Araújo
authors.forename: Beatriz
authors.initials: B
authors.lastname: Amin
authors.forename: Flávia
authors.initials: F
authors.lastname: Fazoli
authors.forename: Luiz José de
authors.initials: LJ
authors.lastname: Souza
authors.forename: Oswaldo Gonçalves
authors.initials: OG
authors.lastname: Cruz
authors.forename: Rivaldo Venâncio da
authors.initials: RV
authors.lastname: Cunha
authors.forename: Delso do
authors.initials: Dd
authors.lastname: Nascimento
authors.forename: Iris Bucher
authors.initials: IB
authors.lastname: Froes
authors.forename: Rita Maria Ribeiro
authors.initials: RM
authors.lastname: Nogueira
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D015331:Cohort Studies; D003402:Creatine Kinase / Q000097:blood; D003715:Dengue / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000097:blood / Q000821:virology*; D008111:Liver Function Tests; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D011517:Prothrombin Time; D012720:Severity of Illness Index
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D003402:Creatine Kinase; D001663:Bilirubin