Dengue Fever Can Cause Mild Elevation in SGOT and SGPT Levels
Yes, dengue fever commonly causes mild to moderate elevation in SGOT (AST) and SGPT (ALT) levels. Liver involvement is a frequent finding in dengue infection, with elevated transaminases observed in up to 74.2% of dengue patients 1.
Pattern of Liver Enzyme Elevation in Dengue
- SGOT (AST) elevation is more common than SGPT (ALT) elevation in dengue patients, with studies showing SGOT was elevated in 66.7-91.7% of patients while SGPT was elevated in 42.4-91.7% of patients, depending on disease severity 1.
- Liver enzyme elevations typically peak around day 6-7 of illness, with the highest AST levels observed on day 6 2.
- The elevation in liver enzymes correlates with disease severity - patients with severe dengue show significantly higher levels of both AST and GGT compared to those with non-severe dengue, particularly on days 5 and 6 of illness 2.
Mechanism of Liver Involvement
- Multiple factors contribute to liver dysfunction in dengue, including:
- The peak of AST levels typically occurs 24 hours after the peak viremia and 24 hours before maximum fluid leakage, suggesting both viral and immunological mechanisms 2.
Clinical Significance
- Elevated transaminases in dengue should be monitored as they can indicate disease progression and severity 1.
- In some severe cases, AST and ALT values can exceed 1000 IU/L even in the absence of fluid leakage or hemoconcentration 2.
- Hepatomegaly is observed in approximately 34% of dengue cases and may be associated with more severe disease 3.
- Studies have shown that SGOT and SGPT levels negatively correlate with platelet count (p<0.0001), suggesting that increasing transaminase levels may parallel decreasing platelet counts 1.
Monitoring Recommendations
- Liver function tests should be included as routine investigations in dengue patients to understand disease severity and prognosis 3.
- Early liver function tests may not reflect the full extent of liver involvement since hepatic injury typically peaks around days 6-7 of illness 2.
- In addition to transaminases, monitoring for hypoalbuminemia and A:G ratio reversal is important as these are significantly more common in severe dengue (p<0.0001) 1.
Prognostic Value
- While liver enzyme elevations are common in dengue, some studies suggest that the predictive value of transaminase elevation during the febrile phase for determining disease severity may be limited 4.
- A 10-fold increase in SGOT and SGPT levels has been associated with higher mortality in pediatric dengue cases 3.
Dengue-associated liver injury is typically self-limiting with supportive care, but monitoring liver function is important for assessing disease severity and guiding management decisions.