Liver Dysfunctions in Dengue Infection: An Update on its Pathogenesis

Dengue fever (dengue hemorrhagic fever or dengue shock syndrome) is a virus infection and comes under one of the major vector-borne diseases [1,2]. Dengue infection has now become the global health threat [2]. High fever, chills, rash and strong headache are the more common clinical features of this disease [3,4]. In addition to these symptoms, some special clinical manifestations appear in response to severe dengue cases where viremia is high [5]. Liver dysfunction is one of the atypical forms of clinical manifestation in the dengue infection [3]. The clinical feature of hepatic dysfunctions in dengue patients are increased liver size and elevated levels of liver enzymes mainly transaminases [4,6]. The increase in size of gallbladder was also observed as early clinical manifestations in dengue patients [7]. Around 46% of dengue infected patients from Indonesia were diagnosed to have enlarged liver size. [8]. The other atypical clinical symptoms of dengue were nausea and abdominal pain [9]. Some dengue patients also manifest jaundice and hyperbilirubinemia [4,10]. However, the number of patients is still very less having liver dysfunction with dengue infections [3]. A wide number of reports have suggested the role of immune cells and mediators of inflammation in the liver dysfunctions however, the exact mechanism is still not clear [11-13]. In this article, we discuss some facts and role of immune components involved in the dysfunctions of liver in dengue fever [14].