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Liver enzymes increased 100 times because of dengue fever

The patient had a history of hemolytic anemia, had a history of dengue fever in 2018. In this re-infection, the child had a blood clotting disorder, severe liver failure, liver enzymes increased 100 times higher than normal.

On May 30, Ho Chi Minh City Children’s Hospital 1 said that a child with a very severe dengue fever was saved. It is a 7-year-old girl named LV, living in Ca Mau.

V. high fever continuously for 4 days. On the 5th day, V. vomited a lot, so he went to the local medical center. Here, the patient received fluids, tests showed normal liver enzymes.

However, the baby still had a fever, nausea and vomiting, so the family moved to Children’s Hospital 1 in Ho Chi Minh City on May 19. The test showed an increase in liver enzymes 10 times higher than normal. She has a history of hemolytic anemia (Thalassaemia) and had a dengue fever 4 years ago.

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The patient was in a hepatic coma due to re-infection with dengue fever. Photo: BVCC

After 12 hours of admission, V.’s state of consciousness deteriorated, comatose, and jaundiced much. Worryingly, liver function decreased, liver enlargement with liver enzymes continued to increase 100 times higher than normal, severe blood clotting disorder. Immediately, the baby was intubated to help with breathing and transferred to the Intensive Care Unit – Anti-poison.

At the Intensive Care Unit – Anti-toxic, V. continued to receive respiratory support, fight cerebral edema, treat severe acute liver failure with N-Acetyl cysteine, continuous dialysis, blood transfusion and blood products.

At the same time, doctors conduct tests to look for the cause of liver damage such as Dengue hemorrhagic fever, infection, viral hepatitis, autoimmune hepatitis, drug poisoning and metabolic disease…

Despite intensive treatment, the patient still had deep anesthesia, severe liver failure and coagulation disorders. Doctors consulted and decided to exchange large volume of plasma in combination with continuous dialysis for the baby to replace liver function and stabilize blood clotting function.

This decision had unexpected results after that, the liver damage stopped and liver function gradually improved. Test results confirmed that the cause of the condition was dengue hemorrhagic fever. After more than 1 week of intensive treatment, the patient made good progress, stopped dialysis and weaned off the ventilator. The baby was transferred to the Dengue department on May 28 for further monitoring. The baby is expected to be discharged from the hospital in a few days.

Assoc.BS Pham Van Quang, Head of Intensive Care Unit – Anti-poison, Children’s Hospital 1 warned, many children with severe dengue fever were hospitalized because of cardiovascular collapse and multi-organ failure. In which, severe acute liver failure causes hepatic coma, severe bleeding can lead to death.

“Parents must always be vigilant about Dengue hemorrhagic fever. Children with fever for 2-3 days or more must be examined at a medical facility for early detection and timely treatment,” he said.

Since the beginning of the year, the total number of dengue fever cases in Ho Chi Minh City is nearly 10,000 cases, an increase of 44% over the same period in 2021, of which the number of severe cases increases 7 times. The number of cases is concentrated in the districts of Binh Tan, District 12, Tan Phu District, Binh Chanh District, Cu Chi District, and Hoc Mon District.

Also today, Ho Chi Minh City launched a campaign to respond to the 12th “ASEAN Day Against Dengue Fever” in 2022.

Linh Giao

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Doctors show how to safely reduce fever for children with dengue feverUsing the wrong antipyretic can cause a child to have a severe dengue fever. Even the right medicine, if taken in the wrong way, can harm a child’s liver.

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