ArticleBMC infectious diseases2021
Use of intravenous N-acetylcysteine in acute severe hepatitis due to severe dengue infection: a case series.
Article in BMC infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 24 citations in OpenAlex.
- Dengue virus infection.Nature reviews. Disease primers · 2026Review
- Intravenous N-Acetylcysteine in Patients With Dengue Fever With Marked Aminotransferase Elevation: Prospective Comparative Study.Interactive journal of medical research · 2026Article
- The Case for N-acetylcysteine in Dengue Associated Liver Injury: Time for Definitive Evidence.Open forum infectious diseases · 2026Article
- Dengue Viral Infection and Associated Liver Disease.Journal of clinical and translational hepatology · 2026Article
- Transplant-free survival in dengue-associated acute liver failure: Current evidence and future directions.World journal of virology · 2026Review
- The Impacts of Dengue Virus Infection on Mitochondrial Functions and Dynamics.International journal of molecular sciences · 2025Review
- Nine fatal cases of dengue: a case series from an intensive care unit in Sri Lanka.Tropical medicine and health · 2024Article
- The Use and Potential Benefits of N-Acetylcysteine in Non-Acetaminophen Acute Liver Failure: An Etiology-Based Review.Biomedicines · 2024Review
- Severe dengue infection unmasking drug-induced liver injury: Successful management with N-acetylcysteine.Clinical case reports · 2024Article
- Repurposing N-acetylcysteine for management of non-acetaminophen induced acute liver failure: an evidence scan from a global health perspective.Translational gastroenterology and hepatology · 2024Article
- The Role of Glutathione in Selected Viral Diseases.Antioxidants (Basel, Switzerland) · 2023Review
- Dengue infection: Global importance, immunopathology and management.Clinical medicine (London, England) · 2022Article
- N-acetylcysteine for non-acetaminophen induced acute liver failure: A review.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology AssociationReview
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDengue 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.
methodsA 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.
resultsThe 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.
conclusionMajority 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.
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