Ali Hassan Abro, Ahmed Ms Abdou, Abdulla M Ustadi, Hina Syeda Hussaini, Nadeem Younis Javeed, Ahmed Alhaj Saleh, Dujana A Hamed.
Hepatic dysfunction is frequent in varicella infection.
Rawal Med J Nov ;33(2):201-4.

Objective: To determine frequency and severity of hepatic dysfunction in adult chickenpox patients admitted in our hospital. Material and Methods: This was a hospital based descriptive study conducted from January 2005 to December 2007 at the Infectious Diseases Unit, Rashid hospital Dubai, UAE. The demographics, clinical information, radiological and biochemical changes observed in each patient were entered in a proforma. Full blood count, liver function tests, blood sugar, urea and electrolytes were done for all the patients, whereas, patients with clinical and/or biochemical evidence of hepatic dysfunction were subjected to viral hepatitis serology, coagulation profile, blood culture and ultrasound abdomen. Management was done as per standard guidelines for the management of chickenpox and its complications. Results: A total of 105 patients were entered into the study. Serum alanine transaminases (ALT) levels were above the reference range in 50.9%. Among the 52 patients with raised serum ALT levels, 16 (30.7%) had levels >3 times, 4 (7.6%) had >5 times and 5 (9.6%) had >10 times of normal levels. Serum bilirubin was increased above the normal value in 20% and was greater than 3-folds in 4.9%. High frequency of thrombocytopenia (p<0.009), pneumonia (p0.004), impaired renal function (p<0.01) and disturbed coagulation profile (p<0.01) were observed in patients with hepatic dysfunction. Overall, five (4.9%) patients expired and two (1.9%) of them had acute fulminant hepatic failure. Conclusion: We observed that liver is frequently involved in adult chickenpox patients and the severity of hepatic dysfunction ranges from mild elevation of transaminases levels to acute fulminant hepatic failure. (Rawal Med J 2008;33:201-204).

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