ROLE OF SERUM FERRITIN AND SERUM AMINOTRANSFERASES IN PREDICTING THE SEVERITY IN DENGUE FEVER WITH THROMBOCYTOPENIA

BACKGROUND Dengue fever is an important cause of febrile illness in the tropical and subtropical areas and over 2.5 billion people, over 40% of the world population are now at risk from dengue(1). WHO currently estimates that there may be 50-100 million dengue infections worldwide every year. 1 In India between 2015 and 2017, out of 4,17,480 cases, 790 deaths have been reported according NVBDCP data. 2 This study aims at determining the role of serum ferritin and serum aminotransferases in predicting severity of dengue patients with thrombocytopenia. MATERIALS AND METHODS It is a cross sectional observational study conducted on 100 patients. Patients were assessed by clinical WHO criteria and were investigated for severity of dengue. Severity of dengue and its association with serum ferritin and serum aminotransferase were analysed using student 't' test and ROC curve was plotted to find the sensitivity and specificity. RESULTS In our study conducted on 100 patients, the age distribution was between 18 yrs. to 65 yrs. with mean age of 32 +/- 10 yrs. Male to female ratio was 69: 31. Out of 100 patients, 28 patients had severe dengue as per the WHO 2009 criteria. Significant association was found between raised serum ferritin, AST, ALT and severe dengue (p< 0.001). ROC curve shows that AST with best cut-off of 380 IU/L predicts the severity of dengue with sensitivity of 82.1% and specificity of 94.4%, followed by ALT (Sensitivity 82.1% and specificity 93.1 %) and serum ferritin (Sensitivity 85.7% and specificity 87.5%) respectively. CONCLUSION Results of this study shows significant association between raised AST, ALT, serum ferritin and severity of Dengue and these parameters may serve as a potential biomarker in early prediction of severe dengue.