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Dr. Andrew Rynne

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Getting vomiting sensation. Test showed high liver enzymes. Sign of jaundice or dengue infection?

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Dr. Ketan Vagholkar

Gastroenterologist, Surgical

Practicing since :1989

Answered : 883 Questions

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Posted on Wed, 30 Jan 2013 in Liver and Gall Bladder
Question: My son aged 22 fell sick 5 days back. His Dengue profile showed IgG positive (Antibodies 86.21 RU) and IgM & NS1 both negative. Platelet 1.79L. WBC 1900 Now there is no fever after taking papaya leaf juice for three days. The platelet increased to 1.97 L and WBC to 4300. But his SGOT (965)and SGPT (1135) are very high with Bilirubin total at 6.06. He has this vomiting sensation and couldn't eat anything solid. The doctor has given medicine for Jaundice. Is it just jaundice or a result of a secondary Dengue infection? What are we to do?
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Answered by Dr. Ketan Vagholkar 20 minutes later
Hi,
Thanks for writing in.
Dengue causes severe hepatitis. As a result the patient has pain in the right side of the abdomen and alteration in liver function as well as bleeding tendencies.
In your son's case the liver enzymes are still very high. but platelet counts are ok. therefore I would suggest complete bed rest and good supportive care which should comprise of iv fluids to avoid dehydration, high carbohydrate diet, avoidance of fatty and highly protienaceous foods. Antibiotic combination of ciprofloxacin, amikacin and flagyl is necessary. Supportive liver treatment comprising of ornithine containg compounds and bowel clearing agents like lactulose are necessary in view of the jaundiced state. Vitamin K supplements are also advisable. a close watch over his coagulation profile including platelet count is pivitol in the management until he remains afebrile with normalisation of liver function tests.It would be preferable to keep him in hospital for obsevation so that all this treatment can be administered comprehensively under good medical supervision.
I hope this answers your doubt.
With regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ketan Vagholkar 20 minutes later
Thanks a lot Doctor. Is the alarming level of SGOT & SGPT likely to increase further and a cause of worry as we really don't know whether the Dengue virus is still active? Can Papaya leaf juice be administered now in case the virus and the antibodies are active along with other medication?
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Answered by Dr. Ketan Vagholkar 4 hours later
Hi,
As long as the liver function is altered your son needs to take utmost care as advised by me. It means the process of healing has still not commenced. One cannot predict if the enzymes are going to increase . Only if good supportive care is administered can one expect a recovery of the liver which happens to be a self remitting course.The fact that there is Ig G antibody titer suggests that the body is fighting against the pathogen.
Regarding papaya juice I have no idea whatsoever.
I would suggest not to give any uncooked food items at all.
I hope this answers your doubt.
With regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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