title: Outcome of Severe Dengue Viral Infection-caused Acute Liver Failure in Thai Children.
abstract: To determine clinical course and outcomes of liver functions in children with dengue viral infection-caused acute liver failure (ALF), the records of patients aged <15 years attending our institution during 1989-2011 were reviewed. Of the 41 ALF patients, 2, 6 and 33 patients had dengue hemorrhagic fever grade II, III and IV, respectively. Multiorgan failure including respiratory failure, massive bleeding and acute kidney injury occurred in 80.0%, 96.0% and 84.0% of the ALF cases, respectively, with an overall fatality rate of 68.3%. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were highest on the day that the patient developed ALF. Lactate dehydrogenase levels had positive correlations with AST (r = 0.95) and ALT (r = 0.87) (all p < 0.01). The median (interquartile range) days before the AST and ALT levels returned to lower than 200 U/L after the ALF were 10.5 (8.8, 12.8) and 10.5 (7.8, 14.0) days, respectively.
authors: Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand kamolwish@gmail.com lkamolwi@medicine.psu.ac.th.
authors: Kamolwish
authors: K
authors: Laoprasopwattana
authors: Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
authors: Puthachat
authors: P
authors: Jundee
authors: Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
authors: Pornpimol
authors: P
authors: Pruekprasert
authors: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
authors: Alan
authors: A
authors: Geater
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000821:virology; D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D002648:Child; D003716:Dengue Virus; D005260:Female; D006470:Hemorrhage / Q000150:complications*; D006525:Hepatitis, Viral, Human / Q000821:virology*; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008099:Liver / Q000503:physiopathology; D017114:Liver Failure, Acute / Q000209:etiology / Q000821:virology*; D008111:Liver Function Tests; D008297:Male; D012131:Respiratory Insufficiency / Q000150:complications*; D012189:Retrospective Studies; D019595:Severe Dengue / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D013785:Thailand / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: acute liver failure; dengue hemorrhagic fever; dengue shock syndrome; dengue viral infection