Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 6 Issue 5

Evaluation of Biochemical Markers of Hemophagocytic Lymphohistiocytosis with Severity and Outcome of Dengue Fever

Tarun Betha1, Ajit Tambolkar2, Vihita Kulkarni-Nivargi3, Arun Bahulikar4 and Deepak Phalgune5*

1DNB (Medicine), Senior Resident, Department of Medicine, Poona Hospital and Research Centre, Pune, India
2MD (Medicine), Consultant Physician, Department of Medicine, Poona Hospital and Research Centre, Pune, India
3DNB (Medicine), Consultant Physician, Department of Medicine, Poona Hospital and Research Centre, Pune, India
4MD (Medicine), HoD and Consultant Physician, Department of Medicine, Poona Hospital and Research Centre, Pune, India
5MD (P & SM), PhD, Research Consultant, Department of Research, Poona Hospital and Research Centre, Pune, India

*Corresponding Author: Deepak Phalgune, MD (P & SM), PhD, Research Consultant, Department of Research, Poona Hospital and Research Centre, Pune, India.

Received: March 14, 2022; Published: April 20, 2022

Abstract

Background: The aim of the present study was to identify an association between biochemical markers of hemophagocytic lymphohistiocytosis such as serum ferritin, serum triglycerides, serum fibrinogen and serum lactate dehydrogenase with the severity of dengue fever and disease outcome.

Material and Methods: Ninety patients aged ≥ 18 years with dengue fever confirmed with a serology- dengue non-structural protein 1 antigen-positive were included for this prospective observational study. The patients underwent tests that included serum ferritin, serum triglycerides, serum lactate dehydrogenase, and serum fibrinogen. The primary outcome measure was to find an association of serum triglycerides, serum lactate dehydrogenase,, serum ferritin and serum fibrinogen with the severity of dengue disease.

Results: The median serum ferritin (870.0 ng/mL Vs 95.0 ng/mL), the mean serum lactate dehydrogenase (235 ± 36 U/l Vs 192 ± 24 U/l) and mean serum triglyceride (230 ± 33 mg/dL Vs 192 ± 24 mg/dL) were significantly higher in severe dengue fever patients as compared to dengue fever patients. The mean fibrinogen was 180 ± 45 mg/dL and 197 ± 46 mg/dL in severe dengue fever patients and dengue fever patients respectively (p-value = 0.149).

Conclusions: Serum ferritin, serum lactate dehydrogenase and serum triglyceride levels were found to have a significant association with dengue disease severity.

Keywords: Dengue Fever; Serum Ferritin; Serum Fibrinogen; Serum Lactate Dehydrogenase; Serum Triglycerides

References

  1. Bhatt S., et al. “The global distribution and burden of dengue”. Nature7446 (2013): 504-547.
  2. Muller DA., et al. “Clinical and laboratory diagnosis of dengue virus infection”. Journal of Infectious DiseaseS2 (2017): S89-S95.
  3. Malavige GN and Ogg GS. “Pathogenesis of vascular leak in dengue virus infection”. Immunology3 (2017): 261-269.
  4. Dissanayake HA and Seneviratne SL. “Liver involvement in dengue viral infections”. Reviews in Medical Virology 2 (2018): e1971.
  5. Tremblay N., et al. “The interplay between dengue virus and the human innate immune system: A game of hide and seek”. Vaccines (Basel)4 (2019): 145-165.
  6. Ellis EM., et al. “Incidence and Risk Factors for Developing Dengue-Associated Hemophagocytic Lymphohistiocytosis in Puerto Rico, 2008 – 2013”. PLOS Neglected Tropical Diseases8 (2016): e0004939.
  7. Madkaikar M., et al. “Current Updates on Classification, Diagnosis and Treatment of Hemophagocytic Lymphohistiocytosis (HLH)”. Indian Journal of Pediatrics5 (2016): 434-443.
  8. Sirikutt P and Kalayanarooj S. “Serum lactate and lactate dehydrogenase as parameters for the prediction of dengue severity”. Journal of the Medical Association of Thailand 97 (2014): S220-231.
  9. Okamoto M., et al. “Analysis of triglyceride value in the diagnosis and treatment response of secondary hemophagocytic syndrome”. Internal Medicine10 (2009): 775-781.
  10. Balwierz W., et al. “Hemophagocytic lymphohistiocytosis: diagnostic problems in pediatrics”. Przegl Lek.6 (2010): 417-424.
  11. Raju S., et al. “Hemophagocytic Lymphohistiocytosis Syndrome in Dengue Hemorrhagic Fever”. Indian Journal of Pediatrics12 (2014): 1381-1383.
  12. Allen CE., et al. “Highly elevated ferritin levels and the diagnosis of hemophagocytic lymphohistiocytosis”. Pediatric Blood Cancer6 (2008): 1227-1235.
  13. Kam KQ., et al. “Dengue-associated hemophagocytic lymphohistiocytosis: A rare complication of a common infection in Singapore”. Pediatric Hematology and Oncology 6 (2018): e377-379.
  14. Bhattacharya D., et al. “Severe Dengue and Associated Hemophagocytic Lymphohistiocytosis in PICU”. Indian Journal of Pediatrics12 (2019): 1094-1098.
  15. Chung SM., et al. “Dengue-associated hemophagocytic lymphohistiocytosis in an adult A case report and literature review”. Medicine (Baltimore)8 (2017): e6159.
  16. Giang HTN., et al. “Dengue hemophagocytic syndrome: A systematic review and meta-analysis on epidemiology, clinical signs, outcomes, and risk factors”. Reviews in Medical Virology 6 (2018): e2005.
  17. Morra ME., et al. “Definitions for warning signs and signs of severe dengue according to the WHO 2009 classification: Systematic review of literature”. Reviews in Medical Virology 28 (2018): e1979.
  18. Switala JR., et al. “Serum ferritin is a cost-effective laboratory marker for hemophagocytic lymphohistiocytosis in the developing world”. Pediatric Hematology and Oncology 3 (2012): e89-92.
  19. Charan J and Biswas T. “How to calculate sample size for different study designs in medical research? Vol. 35”. Indian Journal of Psychological Medicine 35 (2013): 121-126.
  20. Prakash O., et al. “Observation on dengue cases from a virus diagnostic laboratory of a tertiary care hospital in North India”. Indian Journal of Medical Research 7 (2015): 7-11.
  21. Lin RJ., et al. “Dengue in the elderly: a review”. Expert Review of Anti-infective Therapy 8 (2017): 729-735.
  22. Rowe EK., et al. “Challenges in Dengue Fever in the Elderly: Atypical Presentation and Risk of Severe Dengue and Hospital-Acquired Infection”. PLOS Neglected Tropical Diseases4 (2014): e2777.
  23. Opal SM., et al. “The immunopathogenesis of sepsis in elderly patients”. Clinical Infection Disease7 (2005): S504-512.
  24. Lee I-K., et al. “Clinical and laboratory characteristics and risk factors for fatality in elderly patients with dengue hemorrhagic fever”. American Journal of Tropical Medicine and Hygiene 2 (2008): 149-153.
  25. Valero N., et al. “Differential Oxidative Stress Induced by Dengue Virus in Monocytes from Human Neonates, Adult and Elderly Individuals”. PLoS One9 (2013).
  26. Soundravally R., et al. “Oxidative stress in severe dengue viral infection: Association of thrombocytopenia with lipid peroxidation”. Platelets 6 (2008): 447-454.
  27. Abualamah WA., et al. “Determining Risk Factors for Dengue Fever Severity in Jeddah City, a Case-Control Study (2017)”. Polish Journal of Microbiology3 (2020): 331-337.
  28. Soundravally R., et al. “Ferritin levels predict severe dengue”. Infection1 (2015): 13-19.
  29. Rao P., et al. “Correlation of Clinical Severity and Laboratory Parameters with Various Serotypes in Dengue Virus: A Hospital-Based Study”. International Journal of Microbiology (2020): 6658445.
  30. Perveen S., et al. “Relationship Between Serum Lactate Dehydrogenase Levels and Dengue Severity”. Journal of Rawalpindi Medical College 21 (2016): 9-12.
  31. Chen C-Y., et al. “Diabetes mellitus increases severity of thrombocytopenia in dengue-infected patients”. International Journal of Molecular Science2 (2001): 3820-3830.
  32. Vasey B., et al. “Multivariate time-series analysis of biomarkers from a dengue cohort offers new approaches for diagnosis and prognosis”. PLOS Neglected Tropical Diseases6 (2020): e0008199.

Citation

Citation: Tarun Betha., et al. “Evaluation of Biochemical Markers of Hemophagocytic Lymphohistiocytosis with Severity and Outcome of Dengue Fever”.Acta Scientific Medical Sciences 6.5 (2022): 120-126.

Copyright

Copyright: © 2022 Deepak Phalgune., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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