Félix Djossou1, Guillaume Vesin2, Gaelle Walter2, Loïc Epelboin1, Emilie Mosnier3, Bastien Bidaud2, Philippe Abboud1, Antoine Okandze4, Severine Mattheus5, Narcisse Elenga6, Magalie Demar7, Denis Malvy8, Mathieu Nacher9. 1. Department of Infectious and Tropical Diseases, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana Equipe d'Accueil EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, 97300 Cayenne, French Guiana. 2. Department of Infectious and Tropical Diseases, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana. 3. Department of Infectious and Tropical Diseases, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana Equipe d'Accueil EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, 97300 Cayenne, French Guiana Departement des centres délocalisés de prévention et de soins, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana. 4. Laboratoire Polyvalent, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana. 5. Laboratoire de virologie, Institut Pasteur de la Guyane, 97300 Cayenne, French Guiana. 6. Department of Pediatrics, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana. 7. Equipe d'Accueil EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, 97300 Cayenne, French Guiana Laboratory of Parasitology and Mycology, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana. 8. Unité des Maladies Tropicales et du Voyageur, Centre Hospitalier Universitaire de Bordeaux, France. 9. Equipe d'Accueil EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Université de Guyane, 97300 Cayenne, French Guiana Centre d'Investigation Clinique Antilles Guyane, INSERM 1424, Centre Hospitalier de Cayenne, French Guiana mathieu.nacher66@gmail.com mathieu.nacher@ch-cayenne.fr.
Abstract
BACKGROUND: The objective of the study was to determine the incidence of transaminase elevation during dengue, and its predictive factors. METHODS: In 2013, a longitudinal study was performed using data from all cases of dengue seen in Cayenne Hospital. Cox proportional modeling was used. Signs of major transaminase elevation were defined as an increase in aspartate amino transferase (AST) or alanine amino transferase (ALT) concentration over 10 times the normal value (10N). RESULTS: There were 1574 patients and 13 249 person-days of follow-up. The incidence rate for signs of transaminase elevation (10N) was 0.55 per 100 person-days. Six patients had major transaminase elevation with AST>1000 units (0.43 per 1000 patient-days), and 73 patients (4.6%) developed transaminase elevation with AST >10N. The variables independently associated with major transaminase elevation were hyponatremia, low platelets, dehydration, hematocrit increase, food intolerance, positive nonstructural protein 1 (NS1), age over 15 years and the notion of paracetamol intake. CONCLUSIONS: Although very frequent, the incidence of major transaminase elevation was lower than reported elsewhere perhaps because of good access to care, or of the particular serotype causing this epidemic. The patients with transaminase elevation tended to be older, more severe and taking paracetamol. .
BACKGROUND: The objective of the study was to determine the incidence of transaminase elevation during dengue, and its predictive factors. METHODS: In 2013, a longitudinal study was performed using data from all cases of dengue seen in Cayenne Hospital. Cox proportional modeling was used. Signs of major transaminase elevation were defined as an increase in aspartate amino transferase (AST) or alanine amino transferase (ALT) concentration over 10 times the normal value (10N). RESULTS: There were 1574 patients and 13 249 person-days of follow-up. The incidence rate for signs of transaminase elevation (10N) was 0.55 per 100 person-days. Six patients had major transaminase elevation with AST>1000 units (0.43 per 1000 patient-days), and 73 patients (4.6%) developed transaminase elevation with AST >10N. The variables independently associated with major transaminase elevation were hyponatremia, low platelets, dehydration, hematocrit increase, food intolerance, positive nonstructural protein 1 (NS1), age over 15 years and the notion of paracetamol intake. CONCLUSIONS: Although very frequent, the incidence of major transaminase elevation was lower than reported elsewhere perhaps because of good access to care, or of the particular serotype causing this epidemic. The patients with transaminase elevation tended to be older, more severe and taking paracetamol. .
Authors: Luciana de Almeida Silva Teixeira; Fabiana Prado Dos Santos Nogueira; Gabriel Antonio Nogueira Nascentes Journal: Rev Inst Med Trop Sao Paulo Date: 2017-09-04 Impact factor: 1.846