Ferritin as a Marker of Severe Dengue in Children

Abstract

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.

Hyperferritinemia in Severe Dengue Infection: Single-Center Retrospective Cohort Study

“…However, hyperferritinemia in sd may have several mechanisms, although not all have been fully elucidated. The best-known mechanism suggests that ferritin is a product of highly active Dengue virus disease reflecting greater dengue viremia and culminating in a pro-inflammatory cytokine release and is highest in the critical phase (1, 3, 11). The hyperferritinemia during this phase is helpful to call out dengue severity (10, 12), although some reports suggest that immunomodulation might be helpful to mitigate severe disease (13).…”

“…Elevated ferritin levels serve as acute phase markers and early biomarkers of dengue viral severity, greater dengue viremia, and consequent more extensive immune activation and pro-inflammatory cytokine release (1, 2). Patients with severe dengue ( sd ) infections and extreme elevations of ferritin have greater degrees of thrombocytopenia, shock, and organ failure, with elevated liver transaminases and coagulation disturbances being most frequent (1–3). Most of these patients have a well-defined temporal evolution in disease phases (4).…”

Hiperferitinemia pada Demam Brerdarah Dengue

“…Dalam pemantauan 3-4 minggu setelah pasien dipulangkan, baik kelompok pasien DBD maupun DD memiliki nilai feritin serum yang normal. 10 Reddy dkk 11 melakukan studi yang mencari hubungan kadar feritin dengan enzim hati (SGOT dan SGPT) pada pasien demam dengue dan penyakit lain dengan gejala demam. Rentang usia 120 pasien 3-15 tahun yang memiliki demam lebih dari tiga hari, termasuk dalam subjek studi tersebut.…”

“…Sekhar 10 melakukan studi terhadap 56 anak yang terinfeksi infeksi dengue dengan NS-1 atau IgM/IgG anti-dengue positif. Serupa dengan studi yang telah dibahas sebelumnya, Sekhar dkk juga menghitung kadar feritin serum pada hari ke-5 dan 6 sejak onset klinis pasien DBD dan menemukan bahwa kadar feritin pada kategori pasien DBD lebih tinggi dibanding pada kelompok pasien demam dengue (p<0,05).…”

“…Secara keseluruhan berdasarkan studi tersebut disimpulkan kadar feritin serum bisa dijadikan penanda untuk memprediksi derajat berat ringannya infeksi dengue serta peningkatan kadar feritin >1200 ng/mL yang diperiksakan setelah hari ke-4 onset demam dapat dijadikan acuan untuk memprediksi perburukkan klinis pasien DBD. 10 Dalam studi yang dilakukan Reddy dkk 11 kadar feritin dibandingkan antara pasien demam dengue dengan pasien demam karena penyakit lain. Tidak disebutkan secara spesifik penyakit lain apa yang dimaksud dalam studi tersebut.…”