Successful use of N-acetyl cysteine and activated recombinant factor VII in fulminant hepatic failure and massive bleeding secondary to dengue hemorrhagic fever

Manoj, Edirisooriya Maddumage; Ranasinghe, Gayan; Ragunathan, Murugapillai K

doi:10.4103/0974-2700.142771

Cited by 12 publications

(11 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, the inhibitory effect of MEL was stronger than that of NAC which reduced the viral titer to 1.9 × 10 6 FFU/mL. NAC showed protective activity in fulminant hepatic failure condition and decreased DENV replication in in vitro and in vivo model of DENV infection [ 18 , 19 ]. The foci representative of virus titer in Figure 1 C clearly demonstrates the anti-DENV activity of MEL at 1000 µM concentration.…”

Section: Resultsmentioning

confidence: 99%

Melatonin Inhibits Dengue Virus Infection via the Sirtuin 1-Mediated Interferon Pathway

Morchang

Malakar

Poonudom

et al. 2021

Viruses

View full text Add to dashboard Cite

Dengue virus (DENV) is the causative pathogen in the life-threatening dengue hemorrhagic fever and dengue shock syndrome. DENV is transmitted to humans via the bite of an infected Aedes mosquito. Approximately 100 million people are infected annually worldwide, and most of those live in tropical and subtropical areas. There is still no effective drug or vaccine for treatment of DENV infection. In this study, we set forth to investigate the effect of melatonin, which is a natural hormone with multiple pharmacological functions, against DENV infection. Treatment with subtoxic doses of melatonin dose-dependently inhibited DENV production. Cross-protection across serotypes and various cell types was also observed. Time-of-addition assay suggested that melatonin exerts its influence during the post-entry step of viral infection. The antiviral activity of melatonin partly originates from activation of the sirtuin pathway since co-treatment with melatonin and the sirtuin 1 (SIRT1) inhibitor reversed the effect of melatonin treatment alone. Moreover, melatonin could modulate the transcription of antiviral genes that aid in suppression of DENV production. This antiviral mechanism of melatonin suggests a possible new strategy for treating DENV infection.

show abstract

Section: Resultsmentioning

confidence: 99%

Melatonin Inhibits Dengue Virus Infection via the Sirtuin 1-Mediated Interferon Pathway

Morchang

Malakar

Poonudom

et al. 2021

Viruses

View full text Add to dashboard Cite

show abstract

“…In this case series, 11 patients had early hepatic encephalopathy (grade 1 or 2) and one patient had advanced hepatic encephalopathy (grade 3). The case series published by Kumasena et al [ 18 ] included 5 early stage patients (grade 1 and 2) and 3 late stage patients (grade 3 and 4). All 3 patients with advanced grade patients died while all 5 early stage patients survived.…”

Section: Discussionmentioning

confidence: 99%

“…In the case series by Senanayake et al [ 20 ] on paediatric patients, all 7 patients were in early hepatic encephalopathy and all survived following treatment with NAC. Lim et al described [ 18 ], a 6-year-old child with dengue fever with advanced hepatic encephalopathy i.e. grade 3–4 fully recovered following treatment with NAC.…”

Section: Discussionmentioning

confidence: 99%

“…Use of intravenous NAC has not been studied extensively in dengue patients with severe hepatitis. A few case reports [ 13 – 17 ] and small case series [ 18 ] from Sri Lanka and Malaysia [ 19 ] showed the beneficial effect of NAC in dengue associated acute severe hepatitis. Manoj et al reported a good outcome in a patient with dengue fever associated fulminant hepatic failure with advanced grade of coma i.e.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Use of intravenous N-acetylcysteine in acute severe hepatitis due to severe dengue infection: a case series

et al. 2021

View full text Add to dashboard Cite

Background Dengue fever is a common mosquito borne viral infection. Severe dengue fever associated severe hepatitis carries high mortality. Based on the beneficial effect of N-acetylcysteine (NAC) in paracetamol poisoning and non-acetaminophen induced liver failure, it is used in dengue fever associated hepatitis in clinical practice. We aim to study the reversal of liver enzymes with NAC in the setting of severe hepatitis due to severe dengue infection. Methods A retrospective analysis was conducted on hospitalized 30 adults with severe dengue fever with severe hepatitis. These 30 patients had aspartate transaminase (AST) and alanine transaminases (ALT) more than 500 U/L and/or PT INR (prothrombin time and international normalized ratio) more than 1.5. They were treated with NAC infusion of 100 mg/h for 3 to 5 days. Results The mean age of the group was 49.9 ± 11.46 years and 18 (60%) patients were males. Nineteen patients (63%) developed dengue shock. Of them 12 patients (40%) developed hepatic encephalopathy. Median AST on the day of administration of NAC was 1125 U/L interquartile range (IQR) 1653.25 while median ALT was 752 (IQR 459.25). There was a statistically significant reduction of both ALT (p = 0.034) and AST (p = 0.049) from day 1 to 4 after NAC infusion. Rise of platelet count between day 1 and day 4 also showed statistically significant difference (p = 0.011) but the reduction of prothrombin time and international normalized ratio (PT/INR) from 1 to day 4 did not show statistical significance difference. Mean duration of treatment with NAC was 3.61 ± 0.75 days while mean length of hospital stay was 6.2 ± 1.27 days. Only one patient died (3.3%). None of the patients reported adverse drug reaction due to NAC. Conclusion Majority of patients demonstrated marked clinical and biochemical improvements and they recovered fully. We observed faster and significant recovery of liver enzymes following administration of NAC. Based on the above findings, this study provides preliminary evidence for the beneficial effect of NAC in severe hepatitis in dengue infection with greater survival benefits.

show abstract

“… The patient got cured after NAC administration. NAC might improve oxygen delivery and consumption [ 38 ] Case report Among one hundred and fifty-five patients with ALF, eight of them were identified to have dengue-induced ALF. Seven patients received NAC infusion at 100–150 mg/kg/day for a minimum of five days.…”

Section: Use Of N-acetylcysteine For the Treatment Of Dengue Virus-inmentioning

confidence: 99%

<p>Repurposing of N-Acetylcysteine for the Treatment of Dengue Virus-Induced Acute Liver Failure</p>

Tafere¹,

Wondafrash²,

Demoz³

2020

HMER

View full text Add to dashboard Cite

The prevalence of dengue infection-induced acute liver damage is increasing from time to time. Since it has no specific antiviral treatment in the world, people in endemic areas suffer more from dengue disorders. Thus, there is a need for searching options for the treatment of dengue-induced acute liver failure. N-acetylcysteine, which is used for the treatment of nasal congestion disorder and paracetamol overdose toxicity, could be used as a definitive therapy for dengue virus-induced acute liver disease. Therefore, this review discusses the therapeutic use of N-acetylcysteine for dengue-induced acute liver disease. Various case reports and case series showed that patients received NAC recovered from their clinical status. Additionally, a preclinical study showed that N-acetylcysteine has anti-dengue virus activity. Thus, N-acetylcysteine could be used as a definitive therapy in dengue virus-induced hepatitis. This might encourage researchers to further investigate the importance of N-acetylcysteine for dengue virus-induced hepatitis.

show abstract

Successful use of N-acetyl cysteine and activated recombinant factor VII in fulminant hepatic failure and massive bleeding secondary to dengue hemorrhagic fever

Cited by 12 publications

References 14 publications

Melatonin Inhibits Dengue Virus Infection via the Sirtuin 1-Mediated Interferon Pathway

Melatonin Inhibits Dengue Virus Infection via the Sirtuin 1-Mediated Interferon Pathway

Use of intravenous N-acetylcysteine in acute severe hepatitis due to severe dengue infection: a case series

<p>Repurposing of N-Acetylcysteine for the Treatment of Dengue Virus-Induced Acute Liver Failure</p>

Contact Info

Product

Resources

About