title: A Study on Spectrum of Hepatobiliary Dysfunctions and Pattern of Liver Involvement in Dengue Infection.
abstract: BACKGROUND
  The most common arthropod-borne viral (arboviral) disease in humans is dengue. It is transmitted by female Aedes mosquitoes. These mosquitoes are widely distributed in subtropical and tropical areas of the world. Study of dengue infection and its complications are rare from countries like India.
  
  
  OBJECTIVE
  In this prospective observational cross-sectional study, we intended to assess the frequency and degree of hepatobiliary dysfunction in adult patients with dengue infection presenting to a tertiary-care medical facility.
  
  
  METHODS
  The details of all patients with serologically proved dengue fever admitted to a tertiary care hospital in eastern India from July 2014 to June 2015 were prospectively reviewed. We collected data including routine blood count, Liver Function Test (LFT), Prothrombin Time (PT), Activated Partial Prothrombin Time (APTT), abdominal ultrasonography from 110 patients.
  
  
  RESULTS
  The maximum number of cases were seen in the age group between 46 years and 61 years and of all cases 55.5% were male and 44.5% were female. Pain abdomen and vomiting were the commonest presenting complaints next to fever which was present in all the cases. Elevated liver enzymes, abnormal values of PT and APTT, thrombocytopenia were observed more commonly in Dengue Shock Syndrome (DSS). Gall bladder wall thickening, thrombocytopenia were seen more commonly in both DSS and Dengue Haemorrhagic Fever (DHF). Plasma leakage such as ascites and pleural effusion on USG were seen more frequently in patients with DHF (76.9% and 73.1%) followed by DSS (72% and 68%) and DF (33.9% and 32.2%).
  
  
  CONCLUSIONS
  Hepatobiliary derangement is seen more commonly in severe case of dengue infection. Early recognition of these parameters can also be used as a predictor for assessing the disease severity.
authors.affiliation: Senior Resident, Department of Accident and Emergency, Lady Hardinge Medical College , New Delhi, India .
authors.forename: Dhrubajyoti
authors.initials: D
authors.lastname: Bandyopadhyay
authors.affiliation: Senior Resident, Department of Medicine, RG Kar Medical College , Kolkata, India .
authors.forename: Sayan
authors.initials: S
authors.lastname: Chattaraj
authors.affiliation: Post Graduate Trainee, Department of Internal Medicine, IPGMER , Kolkata, India .
authors.forename: Adrija
authors.initials: A
authors.lastname: Hajra
authors.affiliation: Senior Resident, Department of General Medicine, RG Kar Medical College , Kolkata, India .
authors.forename: Sabyasachi
authors.initials: S
authors.lastname: Mukhopadhyay
authors.affiliation: Post Graduate Trainee, Department of Internal Medicine, RG Kar Medical College , Kolkata, India .
authors.forename: Vijayan
authors.initials: V
authors.lastname: Ganesan
keywords: Dengue fever; Dengue haemorrhagic fever; Dengue shock syndrome