Role of N-acetylcysteine in liver injury due to dengue fever

Trop Doct. 2023 Oct;53(4):475-480. doi: 10.1177/00494755231176317. Epub 2023 Jun 13.

Abstract

Dengue fever (DF) is a common mosquito-borne viral infection which is endemic in Southeast Asia. Liver involvement may vary from asymptomatic elevation of liver enzymes to fulminant hepatitis. Although the valuable effects of N-acetylcysteine (NAC) in paracetamol toxicity and non-paracetamol liver failure have been extensively studied, its use in DF-associated hepatitis remains unclear. We made a literature search in an online format from libraries such as PubMed, Google Scholar, and EMBASE, and selected 33 articles including original research articles, case reports, and systemic analyses. The majority of the articles reviewed had a positive outcome but treatment strategies involved NAC together with supportive care. Hence, data on sole use of NAC from large randomised control trials remain unclear.

Keywords: Dengue fever; N-acetylcysteine; dengue-induced acute liver injury; dengue-induced severe hepatitis; severe dengue.

Publication types

  • Review

MeSH terms

  • Acetaminophen / toxicity
  • Acetylcysteine* / therapeutic use
  • Dengue* / complications
  • Dengue* / drug therapy
  • Humans
  • Liver Failure, Acute* / drug therapy
  • Liver Failure, Acute* / etiology

Substances

  • Acetaminophen
  • Acetylcysteine