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Bleeding From Gums, Fatigue, Elevated SGPT And SGOT Levels. Had Dengue Fever, Low Platelet Count. Reasons?

Posted on Wed, 13 Jun 2012

Question: Query:Male 34, recently recovered from Dengue fever,where platelet dropped to 30k.Had little bleeding from gum.After 7 days of last fever platelet are back to 150k.On 3rd day of fever SGOT and SGPT was 96 and 128,on 5th day it became 244 nd 275 with normal bilirubin and on 7th day it is 219 and 671.Have normal appetite,urine and stool are normal.no stomach ache, during brushing gum bleeds, have weakness. pls suggest your opinion and what can be the cause of high SGOT and SGPT.

Answered by Dr. Dr. Praveen Tayal (8 hours later)

Hello,
Thanks for posting your query.
Normal range for SGPT (ALT) 10-40, SGOT (AST) 10-35. So from your reports it is clear that ALT and AST levels are elevated. ALT and AST elevate in presence of parenchymal damage of liver because of alcohol use or viral hepatitis or any non specific viral infection of the liver parenchyma.
If no infection is found then it can be due to fat deposition in the liver called a fatty liver. This can happen both due to the consumption of alcohol as well as sedentary lifestyle. My first suggestion is to get an ultrasound of the upper abdomen done to rule out fatty liver.

The serum ALT (SGPT) level usually is greater than the AST level in non-alcoholic variant of fatty liver. XXXXXXX (non alcoholic steatohepatitis/ fatty liver) is basically excess fat deposition in the liver along with inflammation.
If fatty liver is found, then you need to restrict your alcohol intake (if you are taking any) and do some regular exercise like brisk walking for 45 min-1 hour daily. You can continue taking Ursodeoxychiloic acid (UDCA)- Udiliv which is supposed to help in reducing the fatty liver.
I hope this answers your query effectively.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Praveen Tayal (4 hours later)

Thanks a lot for your detailed response.Please let me know can Dengue be a cause of this so abnormal level of ALT and AST. If at all i have Hepatitis, how to confirm?

Answered by Dr. Dr. Praveen Tayal (3 hours later)

Hello,

Thanks for writing again.

Dengue infection is associated with liver damage and in absence of jaundice the damage is mild. Since the infection has subsided, the cause for rising liver enzymes now should be investigated.

Hepatitis can be diagnosed by some simple blood tests by detecting antigens in the blood sample.

Hope my answer is helpful.

Wish you good and healthy recovery.

Regards.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Praveen Tayal (4 hours later)

If you are suspecting Hepatitis then why bilirubin level is normal.

Answered by Dr. Dr. Praveen Tayal (2 hours later)

Hello.

Thanks for writing back.

It is not necessary that Hepatitis will always be associated with Jaundice or raised bilirubin levels.

Chronic infections do affect liver parenchyma and show abnormal liver enzyme levels. There is no harm in excluding the possibility by doing simple blood tests.

Hope, this explains your doubt.

Wish you speedy recovery.

Regards.

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Above answer was peer-reviewed by : Dr. Jyoti Patil