Dengue induced acute liver failure: A meta summary of case reports

ARTICLE HIGHLIGHTS

Research perspectives

This research sheds light on the complexities of dengue-induced acute liver failure (ALF) and provides a foundation for further investigations and targeted interventions.

Research conclusions

ALF secondary to dengue infection is a rare but critical manifestation, requiring intensive care and organ support. Early recognition is vital for prognostication and timely referral for potential liver transplantation. Intravenous N-acetylcysteine shows promise as a supportive therapy, but large-scale studies are needed to validate its efficacy, dosage, and duration. Despite the challenges associated with liver transplantation in these cases, it remains a therapeutic option in refractory situations.

Research results

Nineteen case reports met the inclusion criteria, revealing a median age of 38 years, female preponderance (52.6%), and a median of 4.5 d from dengue diagnosis to ALF development. Most cases originated from India (36.8%) and Sri Lanka (26.3%). Elevated transaminases, neurological dysfunction, and cardiac support were common. Notably, only one death was reported (5.3% mortality), and most patients recovered with supportive therapy, while two underwent liver transplantation.

Research methods

A systematic search of multiple databases, including PubMed, Reference Citation Analysis, Science Direct, and Google Scholar, was conducted using specific keywords. Inclusion criteria comprised case reports or series with individual patient details and acute liver failure secondary to dengue infection. Data extracted from selected reports included patient demographics, clinical interventions, organ support requirements, and clinical outcomes. Statistical analysis was performed using SPSS, and the PRISMA 2009 checklist guided the meta-summary.

Research objectives

This meta-summary aims to analyze the demographic profile, symptomatology, hospital course, and outcomes of patients with ALF secondary to dengue infection. By reviewing published case reports and case series, we seek to delineate the patterns of liver involvement, identify factors influencing disease severity, and explore potential therapeutic strategies.

Research motivation

The motivation behind this study arises from the scarcity of large-scale data on ALF secondary to dengue, its varied clinical presentations, and the need for tailored therapeutic interventions. Given the rising frequency of dengue cases in both endemic and non-endemic areas, insights into ALF dynamics become crucial for effective management and prognosis.

Research background

Dengue, a prevalent cause of viral hemorrhagic fever, has witnessed an increasing global impact, extending beyond tropical regions. With over five billion people at risk and 400 million annual cases, the spectrum of dengue manifestations has expanded. Though liver involvement in dengue is common, ALF is rare, necessitating a comprehensive under-standing of its demographics, clinical course, and outcomes.