Proteinuria during dengue fever in children

The World Health Organization (WHO) introduced the new dengue classification in 2009. We aimed to assess the association of clinical signs and symptoms with WHO severe dengue classification in clinical practice. A systematic literature search was performed using the databases of PubMed, Embase, and Scopus between 2009 and 2018 according to PRISMA guideline. Meta-analysis was performed with the RevMan software. A random or fixed-effect model was applied to pool odds ratios and 95% confidence intervals of important signs and symptoms across studies. Thirty nine articles from 1790 records were included in this review. In our meta-analysis, signs and symptoms associated with higher risk of severe dengue were comorbidity, vomiting, persistent vomiting, abdominal pain or tenderness, pleural effusion, ascites, epistaxis, gum bleeding, GI bleeding, skin bleeding, lethargy or restlessness, hepatomegaly (>2 cm), increased HCT with decreased platelets, shock, dyspnea, impaired consciousness, thrombocytopenia, elevated AST and ALT, gall bladder wall thickening and secondary infection. This review shows new factors comorbidity, epistaxis, GI and skin bleeding, dyspnea, gall bladder wall thickening and secondary infection may be useful to refine the 2009 classification to triage severe dengue patients.

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Clinical signs and symptoms associated with WHO severe dengue classification: a systematic review and meta-analysis

Htun

Xiong

Pang

2021

Emerging Microbes & Infections

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Detection of Proteinuria by Colorimetric Method and Correlation with Disease Severity in Patients Dengue

Charisma

Farida

Anwari

2021

Indonesian J. Clin. Pathol. Med. Lab.

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Severe dengue virus infection often causes proteinuria through several mechanisms, such as leakage of plasma proteins caused by higher protein filtering in the kidneys. The condition of proteinuria in patients with dengue shock syndrome will affect the management, prognosis, and mortality of patients with dengue virus infection. The objectives of this study were to determine the presence of protein in urine samples in patients in which IgG/IgM dengue was detected, to determine the presence of protein in urine samples in patients without dengue infection, and to determine the relationship between proteinuria in dengue patients and the degree of disease severity. The study was conducted in March-June 2020 at the Clinical Laboratory and Inpatient Clinic of Vita Medika Kepung, Kediri Regency. The method used was the consecutive sampling technique. The minimum sample size was 100 respondents with criteria for suspected dengue infection, onset fever > 4 days, age > 2 years, and no indication of other infectious diseases (blood and urine), divided into two groups, group with positive dengue infection and non-dengue group. The results showed that proteinuria was detected in 26% of respondents, secondary dengue infection and positive serological test of IgG, IgM only IgG were detected in 24 (92.3%) respondents and positive IgG and IgM were found in 2 (7.7%) respondents, this was shown by the p-value = 0.000 in the Chi-Square test with a Prevalence Ratio (PR) value of 11,987. In addition, Chi-Square test results indicated that a higher urine protein/albumin led to more severe disease, with p-value = 0.012 and 0.025 (p <0.05) and PR values of 3.333 and 2.800. The results of this study concluded that there was a close relationship between high levels of protein/albumin in the urine with the degree of disease severity in patients with dengue infection. In addition, an increase in urine protein/albumin levels is always followed by a decrease in serum protein/albumin levels.

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Nephrotic syndrome complicated with severe dengue infection in a child

et al. 2020

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Proteinuria during dengue fever in children

Abstract: Urine dipstick and UPCR do not seem to be very valuable for the triage of the patients at the time of the initial consultation but the observation of a decrease of the UPCR during the course of the illness appears to indicate an evolution towards recovery.

Cited by 4 publications

References 20 publications

Clinical signs and symptoms associated with WHO severe dengue classification: a systematic review and meta-analysis

Clinical signs and symptoms associated with WHO severe dengue classification: a systematic review and meta-analysis

Detection of Proteinuria by Colorimetric Method and Correlation with Disease Severity in Patients Dengue

Nephrotic syndrome complicated with severe dengue infection in a child

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