In a dengue patient, the virus and the painkillers are a double whammy that can leave the liver scarred. During an attack, a patient pops painkillers and paracetamols. When they act, the body exacts a cost for suppressing the pain by affecting the liver since this organ treats all painkillers as poison, even paracetamol. So a patient is caught between taking and not taking medicines and a damaged liver takes months to recover.
A large percentage of dengue patients end up with such liver dysfunction. Experts who have observed the patients said levels of certain enzymes and proteins in patients' blood go up or drop in reference to the normal count indicating liver problems.
Abdominal pain, vomiting and loss of appetite are the earliest symptoms. Yellowish discolouration of the eyes or urine and abdominal tenderness are warning signs of liver damage.
Counselling high-risk patients with underlying medical conditions like diabetes and hypertension, stopping medications like paracetamol, known to deteriorate liver function, is still the first line of care. Patients also need supportive care, proper hydration and consistent monitoring of liver function indicators through blood tests.
Dengue virus attacks the cells that cause inflammation in the liver. The Alanine Aminotransferase (ALT) and Amino Alanine Transferase (AST) enzymes increase in number in the blood during the time and may cause complications including damage to liver.
Liver damage in dengue infection is not preventable, but doctors can reduce paracetamol and other medicines which can cause liver toxicity. Liver involvement is more commonly seen in those who have dengue haemorrhagic fever, a severe form of dengue. Early detection can help save lives.
The most commonly used indicators of liver damage are alanine aminotransferase (ALT) and aspartate aminotransferase (AST), referred to as the SGPT and SGOT.
Levels of these enzymes usually begin to increase from an early stage (day 1-3 of illness) and peak during the second week of illness. Proper medical care can help avert liver damage.