• Jadumani Nayak Associate Professor Department of Medicine S.C.B. Medical College, Cuttack Odisha
  • Sudeshna Behera Assistant professor Department of Biochemistry, IMS & SUM Hospital, Siksha ‘O’ Anusandhan University Bhubaneswar,Odisha
  • Shrikanta K Swain Post graduate studentDepartment of Medicine S.C.B Medical College, CuttackODISHA
  • Smaraka R Panda DM Student Department of Nephrology S.C.B Medical College, CuttackOdisha


Objective: To study of multiorgan dysfunction in patients with dengue and to correlate the severity and clinical outcome with different haematological parameters.

Material & methods: All suspected cases of dengue admitted to Medicine dept within 1 year period were evaluated & classified as DF(dengue fever), DHF(dengue hemorrhagic fever), DSS(dengue shock syndrome).

Results: out of total 150 cases,108 cases were classified as DF, 31 cases as DHF and 11 cases as DSS. Liver involvement was seen in 97.33% cases. Jaundice was observed in 10 cases(6.6%),abnormal AST(aspartate transaminase) in 146 (97.33 %) cases and abnormal ALT(alanine transaminase)in 126 (84%) cases. Bleeding manifestations was reported in 61 patients (40.6%).Presence of GI Bleeding in 17 patients (11.3%) was related to severe disease. Thrombocytopenia was present in 25% of DF cases, and in all cases of DHF and DS. Among these, PT(prothrombin time) was prolonged in 10 cases and aPTT(activated partial thromboplastin time) in 47 patients. Serum Fibrinogen was low in 28.57 % of patients. Multiorgan dysfunction was observed in the form of simultaneous hepatic and renal dysfunction in 3.33 % of cases, hepatic and CNS dysfunction in 2.66% of cases, hepatic & cardiac dysfunction in 2% of cases and all the organ system dysfunction in 0.67% of cases.

Conclusion: The extent of rise of liver enzymes, PT, aPTT & fall of serum fibrinogen, and degree of thrombocytopenia correlated with disease severity. Acute renal failure, encephalitis and myocarditis are manifestations of severe form of dengue. Major organ involvement may occur in simple DF also.


1. Padhi S, Dash M, Panda P, Parida B, Mohanty I, Sahu S, et al. A three year retrospective study on the increasing trend in seroprevalence of dengue infection from southern Odisha, India. Indian J Med Res
2. World Health Organization, Global Alert and Response (GAR). Impact of Dengue. Available from: http://www.who.int/csr/disease/dengue/ impact/en/. [Last accessed on 2013 Feb 19].
3. WHO. Dengue Bulletin. World Health Organization, 2012. Available from: http://www.wpro.who.int/mvp/epidemiology/dengue/Dengue_ Bulletin_Vol36.pdf. [Last assessed on 2016 Jul 01].
4. Seema A, Singh V, Kumar S, Kumar A, Dutta S. The changing clinical spectrum of dengue fever in the 2009 epidemic in North India: A tertiary teaching hospital based study. J Clin Diagn Res 2012;6(6):999-1002.
5. Government of India, Health and Family Welfare Department, National Vector Borne Disease Control Programme (NVBDCP): Dengue cases and deaths in the country since 2007.e2012. Available from: http:// www.nvbdcp.gov.in/dencd.html. [Last assessed on 2012 Dec 05].
6. Anker M, Arima Y. Male-female differences in the number of reported incident dengue fever cases in six Asian countries. Western Pac Surveill Response J 2011;2(2):17-23.
7. Thai KT, Nishiura H, Hoang PL, Tran NT, Phan GT, Le HQ, et al. Age specificity of clinical dengue during primary and secondary infections. PLoS Negl Trop Dis 2011;5(6):e1180.
8. Egger JR, Coleman PG. Age and clinical dengue illness. Emerg Infect
Dis 2007;13:924-5.
9. Isalkar U. Most dengue cases in 14-45 age group: PMC analysis. Pune,

India: The Times of India; 2013.
10. Raut S, Patil S. Dengue in and around Nagpur-central India. J Evol Med
Dent Sci 2012;1(5):853.
11. Chatterjee N, Mukhopadhyay M, Ghosh S, Mondol M, Das C, Patar K.
An observational study of dengue fever in a tertiary care hospital of eastern India. J Assoc Physicians India 2014;62:224-7.
12. Chhina RS, Goyal O, Chhina DK, Goyal P, Kumar R, Puri S. Liver function tests in patients with dengue viral infection. Dengue Bull
13. Makroo RN, Raina V, Kumar P, Kanth RK. Role of platelet transfusion in the management of dengue patients in a tertiary care hospital. Asian J Transfus Sci 2007;1:4-7.
14. Sedhain A, Bhattarai GR, Adhikari S, Shrestha B, Sapkota A. Liver involvement associated with dengue infection during a major outbreak in central Nepal. J Adv Intern Med 2013;02(02):42-6.
15. Wahid SF, Sanusi S, Zawawi MM, Ali RA. A comparison of the pattern of liver involvement in dengue hemorrhagic fever with classic dengue fever. Southeast Asian J Trop Med Public Health 2000;31:259-63.
16. Itha S, Kashyap R, Krishnani N, Saraswat VA, Choudhuri G, Aggarwal R. Profile of liver involvement in dengue virus infection. Natl Med J India 2005;18:127-30.
17. Kumar A, Rao CR, Pandit V, Shetty S, Bammigatti C, Samarasinghe CM.
Clinical manifestations and trend of dengue cases admitted in a tertiary care hospital, Udupi district, Karnataka. Indian J Community Med
18. Karoli R, Fatima J, Siddiqi Z, Kazmi KI, Sultania AR. Clinical profile of dengue infection at a teaching hospital in North India. J Infect Dev Ctries 2012;6(7):551-4.
19. Pone SM, Hökerberg YH, de Oliveira RV, Daumas RP, Pone TM, Pone MV, et al. Clinical and laboratory signs associated to severe dengue disease in hospitalized children. J Pediatr (Rio J) 2016;92:464-71.
20. Kuo CH, Tai DI, Chang-Chien CS, Lan CK, Chiou SS, Liaw YF.
Liver biochemical tests and dengue fever. Am J Trop Med Hyg
21. Ageep AK. Degree of liver injury in dengue virus infection. J Gen Mol
Virol 2012;4(1):1-5.
22. Wong M, Shen E. The utility of liver function tests in dengue. Ann Acad
Med Singapore 2008;37:82-3.
23. White NJ. The treatment of malaria. N Engl J Med 1996;335:800-6.
24. Khan NA, Azhar EI, El-Fiky S, Madani HH, Abuljadial MA, Ashshi AM, et al. Clinical profile and outcome of hospitalized patients during first outbreak of dengue in Makkah, Saudi Arabia. Acta Trop
25. Shah I. Dengue and liver disease. Scand J Infect Dis
26. Hathirat P, Isarangkura P, Srichaikul T, Suvatte V, Mitrakul C. Abnormal hemostasis in dengue hemorrhagic fever. Southeast Asian J Trop Med Public Health 1993;24 Suppl 1:80-5.
27. Isarangkura PB, Pongpanich B, Pintadit P, Phanichyakarn P, Valyasevi A. Hemostatic derangement in dengue haemorrhagic fever. Southeast Asian J Trop Med Public Health 1987;18:331-9.
28. Horvath R, McBride WJ, Hanna J. Clinical features of hospitalized patients during Dengue-3 epidemic in far north Queensland 1997-1999. Dengue Bull 1999;23:24-9.
29. Nair VR, Unnikrishnan D, Satish B, Sahadulla MI. Acute renal failure in dengue fever in the absence of bleeding manifestations or shock. Infect Dis Clin Pract 2005;13(3):142-3.
30. Puccioni-Sohler M, Soares CN, Papaiz-Alvarenga R, Castro MJ, Peralta JM. Neurologic dengue manifestations associated with intrathecal specific immune response. Neurology 2009;27:1413-7.
31. Cam BV, Fonsmark L, Hue NB. Phuong NT, Poulsen A, Heegaard ED.
Prospective case-control study of encephalopathy in children with dengue hemorrhagic fever. Am J Trop Med Hyg 2001;65(6):848-51.
32. Solomon T, Dung NM, Vaughn DW, Kneen R, Thao LT, Raengsakulrach B, et al. Neurological manifestations of dengue infection. Lancet 2000;355:1053-9.
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How to Cite
Nayak, J., S. Behera, S. K. Swain, and S. R. Panda. “A STUDY OF MULTIORGAN DYSFUNCTION IN PATIENTS WITH DENGUE AND ITS CLINICO- HAEMATOLOGICAL CORRELATION WITH SEVERITY.”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 10, no. 2, Feb. 2017, pp. 218-21, doi:10.22159/ajpcr.2017.v10i2.15332.
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