A prominent histopathological feature of fatal dengue cases is hepatic steatosis. However, the association between hepatic steatosis and dengue severity is unknown. We conducted a study to determine the associations of nonalcoholic fatty liver disease (NAFLD) with laboratory markers of dengue severity and length of hospital stay (LOS). A retrospective study was conducted at a private hospital in Jakarta, Indonesia, from December 2011 to December 2016. Bivariate analysis was performed to analyze the associations of laboratory markers of dengue severity and LOS with the presence or absence of NAFLD in no-plasma-leakage (no leakage) and plasma-leakage (leakage) groups. There were 267 dengue-infected patients included in this study. Of these patients, 115 (43.1%) were classified as belonging to the no leakage group, and 152 (56.9%) were classified as belonging to the leakage group. Of the 115 patients belonging to the no leakage group, 53 (46.1%) did not have NAFLD, and 62 (53.9%) had NAFLD. Of the 152 patients belonging to the leakage group, 85 (55.9%) did not have NAFLD, and 67 (44.1%) had NAFLD. Leakage group patients with NAFLD experienced significantly higher hemoconcentration severity (p = 0.04), lower platelet count (p = 0.004) and higher LOS (p = 0.042) than did leakage group patients without NAFLD. The presence of NAFLD in dengue-infected patients with plasma leakage was associated with more severe hemoconcentration, thrombocytopenia and prolonged hospital stay.

ABSTRAKPendahuluan. Salah satu penanda demam berdarah dengue adalah kebocoran plasma dan aktivasi sistem koagulasi yang menyebabkan peningkatan konsentrasi D-dimer akibat degradasi bekuan fibrin. Penelitian ini dilakukan untuk mengetahui hubungan D-dimer dengan parameter laboratorium kebocoran plasma yaitu: trombositopenia, hipoalbuminemia, hemokonsentrasi, dan peningkatan serum glutamic oxaloacetic transaminase (SGOT).Metode. Penelitian retrospektif dilakukan di rumah sakit swasta di Jakarta pada bulan Desember 2016 sampai dengan Maret 2018. Penderita berusia >14 tahun dengan infeksi dengue dan NS-1 positif diikutsertakan ke dalam penelitian ini dan dibagi menjadi kelompok demam dengue (DD) atau demam berdarah dengue (DBD). Uji Mann Whitney digunakan untuk variabel non parametrik, sedangkan uji Spearman digunakan untuk korelasi antara variabel numerik yang tidak terdistribusi normal.Hasil. Tujuh puluh tiga penderita infeksi dengue yang terdiri atas 29 (39,7%) wanita dan 44 (60,3%) pria ikut dalam penelitian ini. Sebanyak 43 (58,9%) merupakan kelompok penderita DD, sedangkan 30 (41,1%) kelompok penderita DBD. Konsentrasi D-dimer fase demam kelompok DBD lebih tinggi dibandingkan dengan kelompok DD (p = 0,004). Didapatkan korelasi lemah antara konsentrasi D-dimer fase demam dengan derajat penurunan trombosit (r = 0,35; p = 0,003) dan korelasi terbalik lemah antara konsentrasi D-dimer fase demam dengan konsentrasi albumin (r = -0,34; p = 0,049). Didapatkan korelasi lemah antara konsentrasi D-dimer fase kritis dengan derajat penurunan trombosit (r = 0,39; p = 0,034) dan korelasi terbalik sedang antara konsentrasi D-dimer fase kritis dengan konsentrasi albumin (r = -0,43; p = 0,032).Simpulan. Konsentrasi D-dimer pada penderita DBD pada fase demam lebih tinggi dibandingkan penderita DD. Konsentrasi D-dimer berkorelasi dengan derajat penurunan trombosit dan hipoalbuminemia. ABSTRACTIntroduction. Plasma leakage and activation of the coagulation system are the pathological hallmark of dengue hemorrhagic fever (DHF) that causes an increase in D-dimer concentration due to the degradation of fibrin clots. This study was conducted to determine the association between of D-dimer and laboratory parameters of plasma leakage, namely: thrombocytopenia, hypoalbuminemia, hemoconcentration and concentration serum glutamic oxaloacetic transaminase (SGOT) in dengue infected patients. Methods. A retrospective study was conducted at private hospitals in Jakarta, from December 2016 to March 2018. Patients >14 years with dengue infection and positive NS-1 were included in this study, and were classified into dengue fever (DF) group or DHF group. The Mann Whitney test was used for non-parametric variables and the Spearman test was used for the correlation for non-normally distributed numeric variables.Results. Seventy-three dengue infected patients included in this study consists of 29 (39.7%) female and 44 (60.3%) male. Total of 43 (58.9%) were classified as DD group, 30 (41.1%) were classified as DHF group. The D-dimer concentration of t...