Acute liver failure associated with severe dengue in a young adult with obesity
Keywords:
acute liver failure, obesity, plasma exchange, severe dengueAbstract
Background: Severe dengue can lead to multiorgan dysfunction, among which acute liver failure (ALF) is a rare but life-threatening complication.
Objective: To present a rare case of ALF associated with severe dengue in a young adult with obesity.
Clinical Case: A 19-year-old obese male college student (BMI 33 kg/m2) who was admitted with persistent high-grade fever for 4 days, headache, myalgia, and vomiting. He was diagnosed with severe dengue presenting with shock, severe hepatic involvement complicated by ALF, sepsis, and respiratory failure. Laboratory findings revealed markedly elevated transaminases (AST 4686 U/L, ALT 1231 U/L), total/direct bilirubin of 91/55 µmol/L, INR of 1.92, serum ammonia of 272 µg/dL, and blood lactate of 8.3 mmol/L. The patient was managed intensively with high-flow nasal cannula oxygen therapy, plasma exchange, L-ornithine L-aspartate infusion, intravenous meropenem, and supportive care in the intensive care unit. His condition gradually improved, with resolution of hepatic and respiratory dysfunction, and he was discharged in stable condition after 10 days of illness.
Conclusion: Acute liver failure can occur in the course of severe dengue, particularly in patients with risk factors such as obesity. Early recognition and aggressive management are essential for improving clinical outcomes.
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Copyright (c) 2025 Bui Thai Huy Nguyen, Quang Khai Tran, Hoang Phuong Tran, Nguyen Tra Uyen Ho, Thai Nguyen Ma, Khanh Toan Le, Duy Linh Nguyen
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