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Muthalibu Muhammed Hunais Shaheed Shiffana Walawe Gamage Nimalka Udayangani


Dengue fever is endemic in Sri Lanka. Liver damage is common in dengue fever. Understanding the pattern change of the liver profile and haematological parameters is crucial for managing dengue patients and minimising liver damage. The purpose of this study was to determine the pattern change in liver profile and the haematological parameters of dengue patients. Sixty apparently healthy volunteers and 169 acute dengue patients aged 20 or older had their blood samples examined. Liver enzymes, albumin, protein, bilirubin, white blood cell count, platelet count, haematocrit, and haemoglobin were measured. There was an increase in aspartate aminotransferase (105.6 IU/L), alanine aminotransferase (82.6 IU/L), and gamma-glutamyl transferase (68.9 IU/L), which were 3.4, 3.9, and 3.2-fold higher, respectively, than those of the control group, suggesting liver injury. Eighty-four percent of patients had raised levels of aspartate aminotransferase, and 74% of patients had elevated levels of alanine aminotransferase, indicating the prominence of aspartate aminotransferase over alanine aminotransferase. The presence of a positive correlation between the levels of aspartate aminotransferase and alanine aminotransferase indicates that the elevation of enzymes is primarily due to a single cause, liver injury. White blood cells and platelet counts were significantly lower. Platelet count demonstrated a negative correlation with both haematocrit and haemoglobin in dengue patients. In conclusion, aspartate aminotransferase was identified as the most significant marker of dengue-associated liver injury, followed by alanine aminotransferase. Low platelet and white blood cell counts were the major unfavourable changes in dengue patients' haematological characteristics.


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Hunais, M. M., Shiffana, S. and Udayangani, W. G. N. (2024) “Effect of dengue infection on liver profile and hematological parameters”, Indonesian Journal of Medical Laboratory Science and Technology, 6(1), pp. 9–17. doi: 10.33086/ijmlst.v6i1.5039.
Aspartate-aminotransferase, Alanine-aminotransferase, Dengue, Platelets, White blood cells


Murugesan A, Manoharan M. Chapter 16 - Dengue virus. In: Ennaji MMBTE and RVP, editor. Academic Press; 2020. p. 281–359. DOI:

Khosavanna RR, Kareko BW, Brady AC, Booty BL, Nix CD, Lyski ZL, et al. Clinical symptoms of dengue infection among patients from a non-endemic area and potential for a predictive model: A multiple logistic regression analysis and decision tree. Am J Trop Med Hyg. 2021;104(1):121–9. DOI:

Ribeiro YP, Falcão LFM, Smith VC, de Sousa JR, Pagliari C, Franco ECS, et al. Comparative analysis of human hepatic lesions in dengue, yellow fever, and chikungunya: revisiting histopathological changes in the light of modern knowledge of cell pathology. Pathogens. 2023;12(5):1–26. DOI:

Leowattana W, Leowattana T. Dengue hemorrhagic fever and the liver. World J Hepatol. 2021;13(12):1968–76. DOI:

Chandola DI, Sitara DB, Negi DN, Kataria DVK. Biomarkers as a diagnostic tool in primary and secondary dengue Infections. Trop J Pathol Microbiol. 2019;5(1):37–42. DOI:

Moriles KE, Azer SA. Alanine amino transferase. StatPearls Publishing. 2020.

Tiwari K, Ahmad S, Irfan S, Srivastava A, Parveen H. A study of the alteration in haematological parameters and liver function test with respect to the severity of dengue fever. Asian J Med Sci. 2021;12(3):93–7. DOI:

Swamy AM, Mahesh PY, Rajashekar ST. Liver function in dengue and its correlation with disease severity: a retrospective cross-sectional observational study in a tertiary care center in Coastal India. Pan Afr Med J. 2021;40(261):1-12. DOI:

Kularatnam GAM, Jasinge E, Gunasena S, Samaranayake D, Senanayake MP, Wickramasinghe VP. Evaluation of biochemical and haematological changes in dengue fever and dengue hemorrhagic fever in Sri Lankan children: A prospective follow up study. BMC Pediatr. 2019;19(1):1–9. DOI:

Ayyadevara R. Clinical profile of dengue and its effect of on biochemical parameters: A hospital-based cross-sectional study. MRIMS J Heal Sci. 2021;9(4):151.

Pathak B, Chakravarty A, Krishnan A. High viral load positively correlates with thrombocytopenia and elevated haematocrit in dengue infected paediatric patients. J Infect Public Health. 2021;14(11):1701–7. DOI:

Jayadas TTP, Kumanan T, Arasaratnam V, Gajapathy K, Surendran SN. The clinical profile, hematological parameters and liver transaminases of dengue NS1 Ag positive patients admitted to Jaffna Teaching Hospital, Sri Lanka. BMC Res Notes. 2019;12(1):8–12. DOI:

Ndrepepa G. Aspartate aminotransferase and cardiovascular disease - A narrative review. J Lab Precis Med. 2021;6:1-17. DOI:

Saara N, Kudchi N, Begum Z. Hematological parameters and aminotransferase changes in dengue infection. Int J Clin Diagnostic Pathol. 2019;2(1):258–60. DOI:

Kalluru PKR, Mamilla M, Valisekka SS, Mandyam S, Calderon ME, Posani S, et al. Aminotransferases in relation to the severity of dengue: a systematic review. Cureus. 2023;15(5):6–13. DOI:

Bhriguvanshi A, Prasad D. Prognostic role of liver function tests in pediatric dengue illness. Int J Infect Dis. 2020 Dec; 101:507–8. DOI:

Pillai AB, Muthuraman KR, Mariappan V, Belur SS, Lokesh S, Rajendiran S. Oxidative stress response in the pathogenesis of dengue virus virulence, disease prognosis and therapeutics: an update. Arch Virol 2019 16412. 2019;164(12):2895–908. DOI:

Chandrasena L, Silva A De, Mel C De, Peiris H, Abesuriya V, Mel S De, et al. Glutathione enzymes and liver injury in acute dengue viral infection. J Biosci Med. 2019;07(10):61–71. DOI:

Teerasarntipan T, Chaiteerakij R, Komolmit P, Tangkijvanich P, Treeprasertsuk S. Acute liver failure and death predictors in patients with dengue-induced severe hepatitis. World J Gastroenterol. 2020;26(33):4983–95. DOI:

Kadadavar SS, Lokapur V, Nadig D, M H P, Masur D. Hematological parameters in dengue fever: A study in tertiary care hospital. Indian J Pathol Oncol. 2020;7(2):218–22. DOI:

Quirino-Teixeira AC, Andrade FB, Pinheiro MBM, Rozini SV, Hottz ED. Platelets in dengue infection: more than a numbers game. Platelets. 2022;33(2):176–83. DOI:

Juliansen A, Budiputri CL, Meliani F, Muljono MP, Heriyanto RS, Chandra S, et al. Clinical characteristics and laboratory parameters in differentiating dengue from other acute febrile illnesses. Egypt Pediatr Assoc Gaz. 2022;70(1). DOI:

Rafi A, Mousumi AN, Ahmed R, Chowdhury RH, Wadood A, Hossain G. Dengue epidemic in a non-endemic zone of Bangladesh: Clinical and laboratory profiles of patients. PLoS Negl Trop Dis. 2020;14(10):1–14. DOI:

Sahassananda D, Thanachartwet V, Chonsawat P, Wongphan B, Chamnanchanunt S, Surabotsophon M, et al. Evaluation of hematocrit in adults with dengue by a laboratory information system. J Trop Med. 2021; 2021:1–9. DOI:

Wisanuvej K, Boonyawat K, Savetamornkul C, Virapongsiri S, Krongvorakul J, Sungkanuparph S, et al. Comparison between blood hemoglobin concentration determined by point-of-care device and complete blood count in adult patients with dengue. PLoS Negl Trop Dis. 2021;15(8):1–11. DOI: