{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T21:13:12Z","timestamp":1770325992234,"version":"3.49.0"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,6,8]],"date-time":"2015-06-08T00:00:00Z","timestamp":1433721600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100013238","name":"Faculty of Medicine, Siriraj Hospital, Mahidol University","doi-asserted-by":"crossref","award":["SIMR078\/2011"],"award-info":[{"award-number":["SIMR078\/2011"]}],"id":[{"id":"10.13039\/501100013238","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Dengue, an endemic infection causing severe flu\u2010like symptoms and fever, is often treated with high\u2010dose acetaminophen that can exceed recommended daily dosages. This leads to hepatotoxicity, although the underlying mechanism is poorly understood. We hypothesised that excessive acetaminophen causes hepatic toxicity in dengue patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate a correlation between elevated serum transaminases and excessive acetaminophen intake, and other aggravating factors of liver injury in dengue cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective observational study obtained blood samples from 150 participants with acute febrile illness for dengue serological tests, blood counts, and the detection of serum transaminases and acetaminophen levels. Other factors were determined by questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 150 participants enrolled, 77 had dengue fever. Abnormally high serum aspartate transaminase and alanine transaminase levels were present in 97.0% and 75.3% of dengue cases respectively. Multivariate analysis of cases with increased serum transaminases more than threefold normal upper limits indicated that male gender (odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) = 3.62, 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 1.38\u20139.42) and consuming &gt;8\u2009g acetaminophen orally (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> = 4.62, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.37\u201313.18) correlated with transaminitis. No correlation was found for other factors such as age, fever day at presentation, body mass index, alcohol intake or dengue severity classification (all <jats:italic>P<\/jats:italic> &gt; 0.05). Chronic alcohol consumption was higher in non\u2010dengue (2.6%) versus dengue cases (27.8%) (<jats:italic>P<\/jats:italic> &lt; 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Most dengue patients had mild\u2010to\u2010moderate transaminitis. Male gender and acetaminophen &gt;8\u2009g were associated with increased serum transaminases. Thus, 1000\u2009mg acetaminophen every 8\u2009h or &lt;3000\u2009mg\/day is recommended for dengue cases. Chronic alcohol consumption might be protective against dengue infection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.12756","type":"journal-article","created":{"date-parts":[[2015,4,1]],"date-time":"2015-04-01T17:36:26Z","timestamp":1427909786000},"page":"653-658","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Is excessive acetaminophen intake associated with transaminitis in adult patients with dengue fever?"],"prefix":"10.1111","volume":"45","author":[{"given":"D.","family":"Pandejpong","sequence":"first","affiliation":[{"name":"Department of Medicine Division of Ambulatory Medicine Faculty of Medicine Siriraj Hospital  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Saengsuri","sequence":"additional","affiliation":[{"name":"Department of Medicine Chumphonkhetudomsakdi Hospital  Chumphon Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Rattarittamrong","sequence":"additional","affiliation":[{"name":"Department of Medicine Siriraj Piyamaharajkarun Hospital  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Rujipattanakul","sequence":"additional","affiliation":[{"name":"Department of Dermatology Samitivej Hospital  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Chouriyagune","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Ambulatory Medicine Faculty of Medicine Siriraj Hospital  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,6,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1110265"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.2165\/00128072-200103110-00004"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2004.019638"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/15563650903232345"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjid.2012.09.007"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2005.10.007"},{"key":"e_1_2_7_8_1","first-page":"694","article-title":"Liver failure and hepatic encephalopathy in dengue haemorrhagic fever\/dengue shock syndrome: a correlation study with acetaminophen usage","volume":"21","author":"Suvatte V","year":"1990","journal-title":"Southeast Asian J Trop Med Public Health"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1413-86702004000600011"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1413-86702004000200006"},{"key":"e_1_2_7_11_1","doi-asserted-by":"crossref","unstructured":"KhongphatthanayothinA MahayosnondA PoovorawanY.Possible cause of liver failure in patient with dengue shock syndrome.2013[cited 2014 May 19]. 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