Diagnosis of Dengue Infection Cases by Serum Lactate Dehydrogenase Profiling Compared
to Dengue NS1 Antigen and Anti-dengue IgM Antibody Detection: A Retrospective Study
Manisha Mandal1, Biswajit Ghosh2, Debashis Halder2, Jayashree Konar3, Nishith Kumar Pal3 and Shyamapada Mandal2*
1Department of Physiology, MGM Medical College and LSK Hospital, Kishanganj, Bihar, India
2Laboratory of Microbiology and Experimental Medicine, Department of Zoology, University of Gour Banga, Malda, India
3Department of Microbiology, NRS Medical College and Hospital, Kolkata, India
*Corresponding Author: Shyamapada Mandal, Professor, Laboratory of Microbiology and Experimental Medicine, Department of Zoology, University of Gour Banga, Malda, West Bengal, India. E-mail: email@example.com
Received: January 19, 2018; Published: February 19, 2018
Dengue is an acute infection with potential fatal complications; the specific antibody detection for which is an indirect method,
and the novel parameter NS1 is reliable for diagnosis of dengue infection, while the serum LDH has been reported to be elevated in
severe dengue. This study attempts to evaluate the association of serum LDH with NS1 antigen and IgM in dengue. The serum NS1
and IgM of dengue cases, by ELISA, were estimated from index values by dividing absorbance at 450 nm with cut-off values. Total
LDH was measured using autoanalyzer. Electropherotyping of LDH was done in 7.5% polyacrylamide gels. The NS1 and IgM param
eters were compared with LDH levels, and analyzed statistically. The NS1 antigens were 35.23 ± 5.37 U (normal < 9 U) with 634.67
± 350.55 U/L LDH (normal ≤250 U/L) (r = -0.57) among 32.33 ± 7.13 years patients and IgM antibodies were 52.38 ± 7.68 U with
451.67 ± 119.74 U/L LDH (r = -0.13) among 25.92 ± 5.01 years patients. The electropherotype showed intense and greater band
pattern when IgM was detected compared to NS1 antigen. Appearance of dengue NS1 antigen as well as anti-dengue IgM in the early
phase of infection was inversely related to the level of serum LDH, and increased LDH activity was found when IgM was detected.
Thus, LDH might be useful as predictive tool in the early course of dengue infection.
Keywords: Dengue; NS1 Antigen; Anti-DENV IgM Antibody; ELISA; Serum Lactate Dehydrogenase; PAGE Analysis
. “Dengue Infection”.
. “Guidelines for clinical management
of dengue fever, dengue haemorrhagic fever and dengue
shock syndrome”. National Vector Borne Diseases Con
trol Programme, Government of India (2008).
. “Fifty years of dengue in India”.
actions of the Royal Society of Tropical Medicine and Hygiene
106.5 (2012): 273-282.
World Health Organization. “Dengue Hemorrhagic Fever:
Diagnosis, Treatment, Prevention and Control 2
WHO Press (1997).
World Health Organization and Special Programme for Re
search and Training in Tropical Diseases. “Dengue Guide
lines for Diagnosis, Treatment, Prevention and Control”.
. “Diagnosis of dengue infection using con
ventional and biosensor based techniques”.
. “Serum lactate and lactate dehydroge
nase as parameters for the prediction of dengue severity”.
Journal of the Medical Association of Thailand
. “Biochemical alterations as mark
ers of Dengue Hemorrhagic Fever”.
American Journal of
Tropical Medicine and Hygiene
78.3 (2008): 370-374.
. “Relationship Between Serum Lactate De
hydrogenase Levels and Dengue Severity”.
Journal of Rawal
pindi Medical College (JRMC)
21.1 (2016): 9-12.
. “Biochemical screening of den
International Journal of Research in Pharmacol
ogy and Pharmacotherapeutics
4.2 (2015): 276-287.
. “Serum lactate as predictor and diagnostic bio
marker of plasma leakage in adult dengue patients”.
35.3 (2016): 213-221.
. “Lactate dehydrogenase isoenzyme profiles
in group a streptococcal infection”.
Journal of Pharmacy
8.7 (2017): 73-76.
. “Electrophoresis of lactate dehydroge
29.1 (1983): 189-195.
. “Univariate theoretical distributions”. In:
Fundamentals of Statistics. 6
edition, Volume I. Kolkata,
India: The World Press Private Limited (1993): 260-307.
. “A survey of the 2014 dengue fever epidemic
in Guangzhou, China”.
Emerging Microbes and Infections
. “Dengue in South-East Asia: An appraisal of
case management and vector control”.
WHO. “Global strategy for Dengue prevention and control
2012-2020”. World Health Organization (2012).
Halstead SB. “Dengue”.
370.9599 (2007): 1644-
. “An antigen capture enzyme-linked immu
nosorbent assay reveals high levels of the dengue virus pro
tein NS1 in the sera of infected patients”.
Journal of Clinical
38.3 (2000): 1053-1057.
. “Dengue diagnosis, advances and chal
International Journal Infectious Diseases
. “Evaluation of two new commercial tests
for the diagnosis of acute dengue virus infection using NS1
antigen detection in human serum”.
PLOS Neglected Tropi-
2.8 (2008): e280.
. “Evaluation of the Panbio dengue virus
nonstructural 1 antigen detection and immunoglobulin M
antibody enzyme-linked immunosorbent assays for the di
agnosis of acute dengue infections in Laos”.
crobiology and Infectious Disease
60.1 (2008): 43-49.
. “Detection of the dengue non-structur
al 1 antigen in cerebral spinal fluid samples using a com
mercially available enzyme-linked immunosorbent assay”.
Journal of Virological Methods
177.1 (2011): 128- 131.
. “Use of dengue NS1 antigen for early di
agnosis of dengue virus infection”.
Southeast Asian Journal
of Tropical Medicine and Public Health
42.3 (2011): 562-
. “The Study of Detection of Dengue
NS1 Antigen and IgM Antibody by ELISA in and around
International Journal of Current Mi-
crobiology and Applied Sciences
4.10 (2015): 416-422.
. “Evaluation of Six Immunoassays for Detec
tion of Dengue Virus-Specific Immunoglobulin M and G
Clinical and Diagnostic Laboratory Immunol-
7.6 (2000): 867-871.
. “Evaluation of commercially avail
able diagnostic tests for the detection of dengue virus NS1
antigen and anti-dengue virus IgM antibody”.
glected Tropical Diseases
8.10 (2014): e3171.
. “Scoring Model to Predict Dengue
Infection in the Early Phase of Illness in Primary Health
Archives of Clinical Microbiology
. “Devising a prognostic predictive scale
based on lactate dehydrogenase levels in dengue”.
2.2 (2015): 69-71.
. “Biochemical parameters (lactate dehy
drogenase, serum albumin) as early predictor of severe
International Journal of Contemporary Pediatrics
4.2 (2017): 464-469.
. “Clinical and Laboratory Features of Severe
Dengue Hepatitis (Liver Failure Mimics): Early Predic
tors of Fatality”.
Journal of Liver and Clinical Research
. “Serum ALT: LDH ratio in ty
phoid fever and acute viral hepatitis”.
47.4 (2010): 339-341.