Mechanisms of hemorrhage in dengue without circulatory collapse.

Krishnamurti, Chitra; Kalayanarooj, Siripen; Cutting, Mary A.; Peat, Raquel A.; Rothwell, Stephen W.; Reid, Thomas J.; Green, Sharone; Nisalak, Ananda; Endy, Timothy P.; Vaughn, David W.; Nimmannitya, Suchitra; Innis, Bruce L.

doi:10.4269/ajtmh.2001.65.840

Cited by 114 publications

(108 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Minor increases in PT were apparent during the early febrile phase in the dengue group but were not significantly different to the changes seen at a similar time in children with OFI. These findings are in agreement with previous studies involving small numbers of patients with mild disease, 20,21 but in addition clearly show the temporal association of the APTT and fibrinogen changes with the period of maximal vascular leakage.…”

Section: Discussionsupporting

confidence: 83%

Hemostatic Changes in Vietnamese Children with Mild Dengue Correlate with the Severity of Vascular Leakage Rather than Bleeding

Wills

Ngoc²,

Vân³

et al. 2009

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. The mechanisms underlying the bleeding manifestations and coagulopathy associated with dengue remain unclear, in part because of the focus of much previous work on severe disease without an appropriate comparison group. We describe detailed clinical and laboratory profiles for a large group of children with dengue of all severities, and a group with similar non-dengue febrile illnesses, all followed prospectively from early presentation through to recovery. Among the dengue-infected patients but not the controls, thrombocytopenia, increased partial thromboplastin times and reduced fibrinogen concentrations were apparent from an early stage, and these abnormalities correlated strongly with the severity and timing of vascular leakage but not bleeding. There was little evidence of procoagulant activation. The findings do not support a primary diagnosis of disseminated intravascular coagulation to explain the intrinsic coagulopathy. An alternative biologically plausible hypothesis is discussed.

show abstract

Section: Discussionsupporting

confidence: 83%

Hemostatic Changes in Vietnamese Children with Mild Dengue Correlate with the Severity of Vascular Leakage Rather than Bleeding

Wills

Ngoc²,

Vân³

et al. 2009

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

show abstract

“…We found the same tendency for WBC count. Dengue virus infected patients also have coagulation alterations, like prolonged thrombin time [40], and sST2 levels were higher when thrombin time was longer. Prolonged thrombin time reflects alterations in fibrinogen levels and / or fibrinogen / fibrin degradation products [41].…”

Section: Discussionmentioning

confidence: 99%

Elevated levels of soluble ST2 protein in dengue virus infected patients

et al. 2008

View full text Add to dashboard Cite

Levels of the soluble form of the interleukin-1 receptor like 1 protein (IL-1RL-1 / ST2) are elevated in the serum of patients with diseases characterized by an inflammatory response. The objective of this study was to determine the concentration of soluble ST2 (sST2) in dengue infected patients during the course of the disease. Twenty four patients with confirmed dengue infection, classified as dengue fever, and eleven patients with other febrile illness (OFI) were evaluated. Levels of sST2 in serum and laboratory variables usually altered during dengue infections were measured. Dengue infected patients had higher serum sST2 levels than OFI at the end of the febrile stage and at defervescence (p=0.0088 and p=0.0004 respectively). Patients with secondary dengue infections had higher serum sST2 levels compared with patients with primary dengue infections (p=0.047 at last day of fever and p=0.030 at defervescence). Furthermore, in dengue infected patients, we found a significant negative correlation of sST2 with platelet and WBC counts, and positive correlation with thrombin time and transaminases activity. We suggest that sST2 could be a potential marker of dengue infection, could be associated with severity or could play a role in the immune response in secondary dengue virus infection.

show abstract

“…A recent in vitro study has reported on the adhesion of platelets to dengue virus-infected endothelial cells [29]. Activated platelets associated with dengue virus and antidengue virus IgM as well as dengue virus-infected endothelial cells may be involved in the mechanism of the increased vascular permeability associated with DHF [30,31].…”

Section: Discussionmentioning

confidence: 99%

Association of increased platelet-associated immunoglobulins with thrombocytopenia and the severity of disease in secondary dengue virus infections

Saito¹,

Oishi²,

Inoue

et al. 2004

Clinical and Experimental Immunology

106

View full text Add to dashboard Cite

SUMMARY Severe thrombocytopenia and increased vascular permeability are two major characteristics of dengue haemorrhagic fever (DHF). To develop a better understanding of the roles of platelet-associated IgG (PAIgG) and IgM (PAIgM) in inducing thrombocytopenia and its severity of disease in patients with secondary dengue virus infection, the relationship between the PAIgG or PAIgM levels and disease severity as well as thrombocytopenia was examined in 78 patients with acute phase secondary infection in a prospective hospital-based study. The decrease in platelet count during the acute phase recovered significantly during the convalescent phase. In contrast, the increased levels of PAIgG or PAIgM that occurred during the acute phase of these patients decreased significantly during the convalescent phase. An inverse correlation between platelet count and PAIgG or PAIgM levels was found in these patients. Anti-dengue virus IgG and IgM activity was found in platelet eluates from 10 patients in an acute phase of secondary infection. Increased levels of PAIgG or PAIgM were significantly higher in DHF than those in dengue fever (DF). An increased level of PAIgM was associated independently with the development of DHF, representing a possible predictor of DHF with a high specificity. Our present data suggest that platelet-associated immunoglobulins involving antidengue virus activity play a pivotal role in the induction of thrombocytopenia and the severity of the disease in secondary dengue virus infections.

show abstract

Mechanisms of hemorrhage in dengue without circulatory collapse.

Cited by 114 publications

References 27 publications

Hemostatic Changes in Vietnamese Children with Mild Dengue Correlate with the Severity of Vascular Leakage Rather than Bleeding

Hemostatic Changes in Vietnamese Children with Mild Dengue Correlate with the Severity of Vascular Leakage Rather than Bleeding

Elevated levels of soluble ST2 protein in dengue virus infected patients

Association of increased platelet-associated immunoglobulins with thrombocytopenia and the severity of disease in secondary dengue virus infections

Contact Info

Product

Resources

About