Can serum ferritin levels predict the severity of dengue early?: an observational study

Petchiappan, Velammal; Hussain, Thaha Mohammed; Thangavelu, Saravanan

doi:10.18203/2320-6012.ijrms20190940

Cited by 11 publications

(16 citation statements)

References 9 publications

(19 reference statements)

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“…There was significant thrombocytopinea in patients having high serum Ferritin level. These findings are in concordance with Jyothi S et al 2018 [13,14] . Hyper-ferritinemia in dengue fever is associated with elevation of SGOT, SGPT and serum creatinine.…”

Section: Discussionsupporting

confidence: 92%

Prognostic significance of hyperferritinemia in dengue: A tertiary health care centre study

Patro¹,

Behera²,

Sahu³

et al. 2021

Int. J. Adv. Res. Med.

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Background: Dengue infection is a major public health threat; early recognition is crucial to improve the survival in severe dengue. For prediction of dengue, various biomarkers are present but they are rarely used. We used serum ferritin to predict the severity at an earlier stage. Methods: This is a prospective observational study conducted in a tertiary health care centre involving 200 dengue cases diagnosed by positive NS1 antigen by ELISA. Serum ferritin was measured in all at the time of diagnosis, day 3 and day 7. We monitored the patients both clinically and biochemically daily and classified them as severe and non-severe according to 2009 WHO criteria. Results: The mean age of the patients was 34.14±12.4 years. Out of 200 patients, 136 (68.0%) patients were male and rest 64 (32.0%) were females, 56 developed severe dengue. All the 200 patients had fever (100%) and arthralgia (100%). Other clinical symptoms like rash, nausea, abdominal pain, persistent vomiting, mucosal bleeding, liver enlargement, clinical fluid accumulation, dengue haemorrhagic fever, dengue shock syndrome, altered sensorium, severe plasma leakage, and patients with ALT more than 1000 U/L was reported in 108 (54.0%), 58 (29.0%), 46 (23.0%), 59 (29.5%), 32 (16.0%), 19 (9.5%), 13 (6.5%), 9 (4.5%), 35 (17.5%), 2 (1%), 12 (6.0%) and 3 (1.5%) patients respectively. The serum ferritin level was correlated with patients having rash, abdominal pain and persisting vomiting both on day 3 and day 7. A negative correlation was observed between serum ferritin level and total platelets count both on day 3 (r=-0.2226; p=0.0016) and day 7 (r=-0.3562; p=0.0001). Patients with severe dengue had significantly low platelet count and higher ferritin levels. Conclusions: Elevated serum ferritin levels can be used as a potential early prognostic marker to predict the severity of dengue infection in clinical practice.

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Section: Discussionsupporting

confidence: 92%

Prognostic significance of hyperferritinemia in dengue: A tertiary health care centre study

Patro¹,

Behera²,

Sahu³

et al. 2021

Int. J. Adv. Res. Med.

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“…12 Coincidental findings were made in a study in Singapore; people over 60 years of age had more extreme dengue occurrence (20.3 percent vs. 14). [12][13][14] Our study show 1,200 ng / ml serum ferritin cut-off level was used to predict the clinical manifestation of DHF. During Days 5, 6, and 7 after the onset of fever, the results for sensitivity were 83, 86, and 92 per cent respectively.…”

Section: Discussionmentioning

confidence: 80%

Ferritin as a Marker of Severe Dengue in Children

Sekhar¹

2020

AJCPN

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Background: The aim is to evaluate ferritin levels in fever caused by dengue virus and their association with the severity of infection with dengue virus in children. Subjects and Methods: It is a Prospective that was done for 1 year in the department of pediatrics. 56 reported cases with a history of dengue fever for clinical evaluation by positive IgG and IgM antibodies and positive NS1 antigen and were included in the sample. All 16-year-old subjects with clinical dengue suspicion presenting in the department of emergency. Results: Out of total of 56 children with mean age of the children were 11.5 years and SD 3.5 years, and 59% were male who were majority. Mean hospital stay duration was 5 3 days. Most of the patients in study discharged in 5-7 days of admission in hospital. The mean serum ferritin levels among cases with DHF were raised than those with DF with significant p-values of< 0.05 on Day 5 and 6 of illness. During Days 5, 6, and 7 after the onset of fever, the results for sensitivity were 83, 86, and 92 per cent respectively. Conclusion: The incidence of hyperferritinaemia in patients infected with dengue virus is suggestive of highly active use of ferritin level in serum is 1,200 ng/ml as a method for predicting progression to DHF starting on Day 4 of the disease and continuing to recover.

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“…Petchiappan et al 29 noted higher ferritin levels were reported on D4 onward during the febrile phase of illness (within 7 days of onset of illness) in severe dengue patients than nonsevere dengue cases. Our study demonstrated an increase in ferritin levels as the severity grade increases and analyzed serum ferritin levels both during febrile, defervescence, or convalescent phase, which is critical as the disease progression to severe dengue occurs after the febrile phase.…”

Section: Discussionmentioning

confidence: 97%

“…Our study also had a higher number of severe dengue cases than this study. 29 Furthermore, in another study in Aruba, which compared serum ferritin levels of 44 dengue patients with those of other febrile illnesses (OFIs), and found significantly elevated ferritin levels on days 6-8 of illness in dengue patients. The higher ferritin levels in dengue patients were associated with higher viral copy numbers on days 2-3 of illness.…”

Section: Discussionmentioning

confidence: 99%

Serum Ferritin As a Prognostic Indicator in Adult Dengue Patients

Suresh

Hanumanthaiha

Ramakrishna

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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Dengue virus (DENV) infection is increasing with rapid urbanization in India. Treatment of DENV infection is mainly supportive with no specific antiviral therapy. Although most patients show mild illness, some have a severe disease course such as dengue hemorrhagic syndrome, dengue shock, multi-organ failure, and death. The cause for severity is not fully understood. Currently, there are no methods available to predict the course of the illness. Hence, it is crucial to develop an early biomarker to predict the course of dengue illness which can aid in vigorous monitoring and early intervention. Here, we tried to establish a correlation between serum ferritin and severity of dengue illness. We measured ferritin levels in 100 dengue-positive cases on day 1 (D1) (febrile phase) and day 4 (D4) (defervescence or convalescent) of admissions to compare the levels with the severity of the disease. On D1, the serum ferritin level was a "good" predictor of severe dengue, with an area under the curve (AUC) of 0.863 with standard error (SE) = 0.043 and a 95% CI from 0.778 to 0.947 (P < 0.05). On D4, serum ferritin was an "excellent" predictor of severe dengue, with an AUC of 0.947 with SE = 0.021 and a 95% CI from 0.907 to 0.988 (P < 0.05). Serum ferritin is an inexpensive and easily accessible biomarker that can assist in monitoring and prognosticating the dengue-positive patients. This biomarker also directs us to explore the underlying pathogenetic mechanism in severe dengue, which can lay a foundation for future targeted therapeutic options to combat severe illness.

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Can serum ferritin levels predict the severity of dengue early?: an observational study

Cited by 11 publications

References 9 publications

Prognostic significance of hyperferritinemia in dengue: A tertiary health care centre study

Prognostic significance of hyperferritinemia in dengue: A tertiary health care centre study

Ferritin as a Marker of Severe Dengue in Children

Serum Ferritin As a Prognostic Indicator in Adult Dengue Patients

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