Which of the following is considered severe organ impairment in dengue?

Elevated levels of AST (aspartate aminotransferase) or ALT (alanine aminotransferase) at or above 1000 indicate significant liver damage or dysfunction, which is a critical aspect of severe organ impairment in the context of dengue fever. In severe cases of dengue, the disease can lead to serious complications, one of which is liver involvement that manifests through these elevated enzyme levels. This elevation suggests that the liver is under significant stress or is affected by the viral infection, thus qualifying it as a severe organ impairment.

In contrast, other options present conditions that do not indicate severe organ impairment. An elevated platelet count, for instance, is not associated with severe organ impairment in dengue; in fact, dengue is commonly characterized by a low platelet count as the disease progresses. Similarly, minor symptoms like headaches and fatigue are common in dengue but do not reflect organ impairment, and normal liver function tests suggest that there is no dysfunction present, contradicting the notion of severe organ impairment.