Evaluation of biochemical and haematological changes in dengue fever and dengue hemorrhagic fever in Sri Lankan children: a prospective follow up study (original) (raw)
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Biochemical alterations as markers of dengue hemorrhagic fever
The American journal of tropical medicine and hygiene, 2008
We evaluated biochemical alterations as predictors of dengue hemorrhagic fever (DHF). Patients with confirmed infection with dengue virus were prospectively evaluated for the first seven days of disease to determine their final clinical outcome. Serum samples taken 48-96 hours after onset of fever were used for biochemical tests. Of 199 patients, 30 developed DHF. Cases of DHF had higher levels of lactate dehydrogenase (LDH), creatine kinase (CK), and aspartate aminotransferase, and lower levels of albumin, total cholesterol, and triglycerides. Multivariate analysis showed that early alterations of CK (hazard ratio [HR] = 6.98, 95% confidence interval [CI] = 2.34-20.85, P = 0.001), LDH (HR = 3.19, 95% CI = 1.01-10.12, P < 0.05), and albumin (HR = 2.54, 95% CI = 1.09-5.92, P = 0.03) were associated with DHF. Triglyceride levels > 160 mg/dL were negatively associated with developing DHF (HR = 0.07, 95% CI = 0.01-0.59, P = 0.01). Early alterations of biochemical markers can predi...
CORRELATING BIOCHEMICAL AND HEMATOLOGICAL PARAMETERS IN PATIENTS WITH DENGUE
Asian Journal of Pharmaceutical and Clinical Research Journal, 2022
Objectives: The objectives of this study were to ascertain the correlation of the various biochemical and hematological parameters to dengue positive status. Methods: Based on review of literature, we calculated the correlation of biochemical and hematological parameters of liver profile in dengue positive and dengue negative patients in a convenience sampling of 140 dengue negative and 49 dengue positive cases. Results: Total bilirubin (TBI), total plasma protein, globulin, and alkaline phosphatase showed inverse correlation to dengue positive status, while albumin/globulin ratio elicited direct correlation. (p˂0.05) Other parameters, namely, random blood sugar, direct bilirubin, indirect bilirubin, albumin, SGPT, and SGOT showed no clear cut correlation with dengue positive or negative status (p>0.05). Conclusions: TBI, total plasma protein, globulin and alkaline phosphatase, and albumin/globulin ratio should be ascertained in a large equal groupsize randomized study to establish their authenticity as prognosticators of the disease.
International Journal of Medical Science and Public Health, 2016
Background: Dengue viral infections are the most important mosquito-borne diseases of the Indian subcontinent and have become a major global public concern. Objective: To evaluate hematological changes in serologically proven patients with clinical manifestations of dengue fever at tertiary care hospital. Materials and Methods: Cases of fever, clinically suspected to be dengue were confirmed by immunochromatographic tests for dengue NS1 antigen and dengue IgM antibody during the period from September 2015 to November 2015. A total of 250 seropositive dengue cases were correlated with clinical features, hematological, and biochemical findings. Result: With the most common clinical feature-high grade fever (95%), the main hematological findings were raised hematocrit (>29%), leukopenia (44%), and thrombocytopenia (59%). Conclusion: Hemoconcentration, leukopenia, thrombocytopenia, raised SGPT, and raised serum bilirubin gave enough clues to test for dengue serology so as to reduce the morbidity and mortality because of this disease.
Assessment of clinical and haematological profile in dengue fever
International Journal of Research in Medical Sciences, 2020
Introduction: Series of biochemical and haematological changes occur during the course of the illness. Physicians should be aware of the most common clinical as well as clinical and biochemical presentations which are important for the clinical management of patients and thus crucial for saving a life. Therefore, this study aimed to highlight the most common clinical features and biochemical findings of dengue cases.Methods: A total of 200 cases of suspected dengue fever were included in the study. The present is the prospective cohort study; samples were selected with sampling technique. A total of 200 cases of suspected dengue fever were included in the study. The frequency of various signs and symptoms and the values of laboratory tests were compared. The results were tabulated and correlated.Results: In our series in clinical manifestations, all cases presented with fever, myalgia was found in 156 patients, headache was found in 106 patients, rashes were present in 28 patients, ...
Evaluation of haematological Parameters in Dengue cases and controls
Research Article , 2023
Background Dengue is a viral infection transmitted to humans through the bite of an infected mosquito. Various clinical and laboratory parameters are used to predict the severity of this disease. Objective This study was aimed at comparing and analysing eight haematological parameters, including haemoglobin, haematocrit, platelet count, three platelet indices [mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW)], total leucocyte and erythrocyte count, in the case of dengue seropositive, dengue seronegative but clinically suspected dengue and healthy controls. Methods We retrospectively analysed patient records from the Central Laboratory of Subharti Hospital, Meerut (UP). In this laboratory based-study, between October 2021 and January 2022, 300 subjects were examined including 200 hospitalised patients with probable dengue fever and 100 healthy subjects. Result The data was evaluated from 200 patients and 100 healthy controls (age between 6-70 years, mean 31 years). Quantitative analysis of patients and controls laboratory data revealed a significant difference in haemoglobin, packed cell volume (PCV), platelet count, and PDW (platelet distribution width) with p-values <0.05. Qualitative analysis of all-haematological parameters, was also statistically verified and had p value < 0.001. Conclusion In addition to platelet count, haemoglobin, PCV, and PDW are useful parameters to assess severity and recovery after dengue diagnosis. Keywords: Dengue fever, CBC, PCV, haemoglobin, platelet count.
Evaluation of Haematological Parameters in Dengue Cases and controls: A retrospective Study
European Chemical Bulletin, 2023
Background Dengue is a viral infection transmitted to humans through the bite of an infected mosquito. Various clinical and laboratory parameters are used to predict the severity of this disease. Objective This study was aimed at comparing and analysing eight haematological parameters, including haemoglobin, haematocrit, platelet count, three platelet indices [mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW)], total leucocyte and erythrocyte count, in the case of dengue seropositive, dengue seronegative but clinically suspected dengue and healthy controls. Methods We retrospectively analysed patient records from the Central Laboratory of Subharti Hospital, Meerut (UP). In this laboratory based-study, between October 2021 and January 2022, 300 subjects were examined including 200 hospitalised patients with probable dengue fever and 100 healthy subjects. Result The data was evaluated from 200 patients and 100 healthy controls (age between 6-70 years, mean 31 years). Quantitative analysis of patients and controls laboratory data revealed a significant difference in haemoglobin, packed cell volume (PCV), platelet count, and PDW (platelet distribution width) with p-values <0.05. Qualitative analysis of all-haematological parameters, was also statistically verified and had p value < 0.001. Conclusion In addition to platelet count, haemoglobin, PCV, and PDW are useful parameters to assess severity and recovery after dengue diagnosis.
Clinical and Laboratory Profile of Children with Dengue Fever and Predictors of Severe Dengue
https://www.ijrrjournal.com/IJRR\_Vol.8\_Issue.8\_Aug2021/IJRR-Abstract01.html, 2021
Objectives: To study the Clinical and Laboratory profile of children upto 12 years of age with Dengue fever and to study the predictors of Severe Dengue among these children. Methods: Design: Descriptive study over 1 year 9 months. Setting: SAT hospital, Thiruvananthapuram, a tertiary care center. Study Population: 204 children aged 1month to 12 years admitted with serologically confirmed dengue fever without any co-infections; consecutive sampling. Procedure: Relevant history, detailed physical examination and investigations were noted. Patients were classified for their severity based on DENGUE guidelines-WHO 2009. Children were followed up till discharge during hospital stay. Categorical values were expressed as proportions and quantitative variables in mean and standard deviation. Association between various study variables and severe dengue were statistically analysed. Results: Mild dengue was seen in 96 children(47.1%), moderate dengue in 78 children(38.2%) and severe dengue in 30 children(14.7%). Mean age of presentation was 6.4 years. Age distribution- infants were 4.4%, 38.7% were between 1 year and 5 years; 56.9% were between 6 and 12 years.51% of children were males. Common clinical presentation was fever (100%), vomiting(46.6%), abdominal pain(32.4%), lethargy(24.5%), myalgia(22%), headache(16.7%) and reduced appetite(15.7%). Mean fever duration was 5 days. Hypotension was noted in 13.2%, Tender hepatomegaly in 44%, signs of plasma leakage in 6%, hypoalbuminemia in 7.8%. Total number of death was 2(1%). Variables with significant association with severe dengue on univariate analysis were Lethargy (p-<0.001, OR- 11.6), reduced appetite (p- <0.001,OR- 17.14), mucosal bleed (p<0.001, OR- 15.45), Fever spike >39◦C (p- 0.001, OR- 4.3), tender hepatomegaly (p- 0.001, OR- 4.2), decreased urine output (p <0.001, OR- 23.04), hypoalbuminemia (p <0.001, OR-43.5), platelet count below 80,000 (p <0.001, OR-4.43), SGOT above 85 (p <0.001, OR-4.9). According to the maximum area under ROC curve, a cutoff of platelet count 80,000 had 75% sensitivity and 60% specificity for predicting severe dengue. Conclusion: Proportion of children developed severe dengue was 14.7%. Independent predictors of severe dengue after multiple logistic regression were Lethargy, Reduced appetite, Reduced urine output and Hypoalbuminemia.
Clinical and laboratory profile of dengue fever patients : A clinical experience
The Journal of the Association of Physicians of India, 2016
Dengue a mosquito borne arboviral disease is caused by one of the serotypes of dengue virus (DEN-1, DEN-2, Den-3, DEN-4) belonging to the family Flaviviridae. These serotypes are antigenically distinct but closely related to each other. Globally 50 million dengue infections are reported annually with annual incidence of 7.5 to 32.5 million cases in India. 1 The first case of dengue fever was reported from Vellore and dengue haemorrhagic fever from Kolkata. 2 The disease is endemic in more than 100 tropical and subtropical ABSTRACT Background: Dengue fever is a mosquito borne arboviral disease which is of global concern. It is endemic in tropical countries with annual incidence of 7.5 to 32.5 million cases. It commonly affects the young adults and paediatric cases of Dengue haemorrhagic fever has high mortality. The objective of this study was to assess the clinical and laboratory profile and outcomes of dengue fever in children of less than 18 years of age. The study was conducted for a period of one year during an outbreak, in a tertiary care hospital of Chennai, Tamilnadu, India. Methods: This was a prospective cross sectional study and 200 cases of dengue fever were enrolled and classified as per WHO guidelines. The clinical profile and demographic profile was recorded in a structured questionnaire form. Haematological parameters were recorded and followed till the day of discharge. The duration of stay was recorded and outcomes were noted. Results: A total of 200 cases with 113 males and 87 females, 177 non severe dengue cases and 23 severe cases of dengue fever were classified. The mean age of admission was 9 years and mean duration of stay in hospital was 4.61 days. Fever was most common presenting symptom (100%) and hepatomegaly (58.5%) was common clinical finding. Bleeding manifestations were seen in severe dengue cases. Statistical significance was seen in rise in SGOT levels, rise in haematocrit and pleural effusion with severe dengue cases and non-severe dengue cases. The case fatality rate was zero. Conclusions: Understanding the knowledge of presentations and associated features would help to predict the severity of the disease. In children, if symptoms like fever, pain, rashes, and vomiting are associated with Hepatomegaly and elevated SGOT in context of low total platelet count, a strong possibility of dengue fever is present, especially in an epidemic setting. Early suspicion and effective management can reduce the severity.
Clinical and biochemical profile of dengue haemorrhagic fever in children in Delhi
Tropical doctor, 2008
The clinical and biochemical profile of dengue haemorrhagic fever (DHF) varies from epidemic to epidemic. We studied children hospitalized with DHF from September 2003 to December 2003. All were diagnosed, managed and monitored according to a standard protocol. Of the 34 who fulfilled the World Health Organization criteria of DHF, 22 (64.6%) were male. All patients presented with fever and hepatomegaly. Examination also revealed splenomegaly in 11 (32.4%), ascites in 6 (17.6%) and pleural effusion in 3 (8.8%). Common bleeding manifestations were positive tourniquet test in 22 (64.7%) and epistaxis in eight (23.5%). Most children had a platelet count of between 20,000/mm(3) and 50,000/mm(3) (56%). Bleeding manifestations were not related to platelet count (P > 0.05). Serum glutamic pyruvic transaminase (SGPT) >40 IU/L was seen in 22 (64.6%) patients, alkaline phosphate (ALP) >400 IU/L in 12 (35.3%) and serum bilirubin…
Pediatric Infectious Disease
Introduction: Dengue viral infection presents with a highly complex pathophysiological, economic, and ecologic problems. Through this study we aim to analyze the changing epidemiology and seasonal clustering of dengue fever cases. Also, we aim to analyze the clinical presentation, biochemical parameters, treatment given, and determine whether they have any association with the disease severity and outcome. Materials and methods: The present cross-sectional, observational study was conducted over a period of 1½ years including a total 255 patients of probable dengue, confirmed dengue, and dengue-like illness (DLI). Statistical association of various qualitative and quantitative parameters of the disease was made with both disease severity and disease outcome. Results: There were 27.8% patients in the age group 10-12 years and 11% infants in our study. Maximum patients were admitted in the postmonsoon months. Fever was the most common symptom and abdominal tenderness was the most common sign. Leucopenia was the most frequent hematological abnormality noted in our study. Mean day of appearance of hematological derangements corroborated with the onset of critical phase of dengue. The NS1 antigen test was found to be most useful for diagnosis with maximum percentage positivity, rapid results, ease of availability, and cost-effectiveness. Mean day of illness for NS1 positivity was 4.6 ± 2.9 days. Ultrasound abdomen was a sensitive test to predict early signs of plasma leakage. Substantial number of patients could be managed with oral fluids only; however, a few required an intravenous (iv) crystalloid bolus at the time of presentation. Blood products were sparingly used in our study. Antibiotic use did not alter disease course and outcome, hence is not recommended. Very few patients needed intensive care unit (ICU) admission. There were 13 deaths (mortality rate of 5.1%) during the study period. The rate of development of complications and also mortality was quite considerable in the DLI group. Hence, from the present study we emphasize that the DLI group should not be alienated from the continuum of spectrum of dengue viral infections. Conclusion: Presence of bleeding, encephalopathy, clinical/radiological signs of plasma leakage, hypotension, hepatomegaly, coagulopathy, deranged liver function test (LFT), and hemoconcentration with thrombocytopenia are indicative of a severe dengue disease and can also be used as surrogate markers for poor prognosis.