Serum lipid profile as predictor of clinical outcome in pediatric patients with dengue infection at a tertiary care hospital

Authors

  • Mohd. Saeed S. Siddiqui Department of Pediatrics, MGM Medical College and Hospital, Aurangabad, Maharashtra, India
  • Amruta Kailash Loya Department of Pediatrics, MGM Medical College and Hospital, Aurangabad, Maharashtra, India
  • Udaykumar Kanumala Department of Pediatrics, MGM Medical College and Hospital, Aurangabad, Maharashtra, India
  • Jagannath R. Kakade Department of Pediatrics, MGM Medical College and Hospital, Aurangabad, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20195209

Keywords:

Biomarkers, Dengue, Lipid profile, Platelet count

Abstract

Background: Dengue is a serious mosquito-borne viral disease which in recent years has become a major international public health concern. Early detection of individuals at risk of developing severe forms of dengue could be possible with the identification of an ideal biomarker, which has been the focus of several research studies. Changes in lipoprotein profile during infection probably are primarily cytokine induced Interactions between microorganisms and lipoproteins occur in viral infections. There have been very few studies that address and elucidate a correlation between dengue fever severity and changes in the lipid profile.

Methods: This study was conducted in paediatric patients with dengue infection of age group between 1 to 18 years MGM Medical College and Tertiary Care Hospital of Aurangabad City.

Results: There was statistically significant association between TG (mg/dl) level and dengue disease category (DF vs DHS+DSS) among the patients. Overall the combine lipids were significantly predicting dengue disease category (DF, DHS and DSS). Serum lipids (triglycerides, LDL and cholesterol) among the patients significantly predict dengue disease category (DF, DHS and DSS). There was negative correlation between triglycerides level and HDL and hospital Stay which was found to be statistically significant.

Conclusions: Reduced serum lipid profile can be used as a cost-effective laboratory investigation prompting a high suspicion of severe dengue infection especially in resource poor setting where serological tests may not be available.

References

World Health Organization. Dengue and Severe Dengue Fact Sheet. Updated April 2016. Available at: http://www.who.int/mediacentre/factsheets/fs117/en/. Accessed on 15th April 2016.

World Health Organization, Special Programme for Research, Training in Tropical Diseases, World Health Organization. Department of Control of Neglected Tropical Diseases, World Health Organization. Epidemic, Pandemic Alert. Dengue: guidelines for diagnosis, treatment, prevention and control. World Health Organization; 2009.

John DV, Lin YS, Perng GC. Biomarkers of severe dengue disease–a review. J Bio Sci. 2015 Dec 1;22(1):83.

Green S, Rothman A. Immunopathological mechanisms in dengue and dengue haemorrhagic fever. Curr Opin Infe Dis. 2006 Oct 1;19(5):429-36.

Al-Muhandis N, Hunter PR. The value of educational messages embedded in a community-based approach to combat dengue fever: a systematic review and meta regression analysis. PLoS Neglec Trop Dis. 2011 Aug 23;5(8):e1278.

Rauchhaus M, Coats AJ, Anker SD. The endotoxin-lipoprotein hypothesis. Lancet. 2000 Sep 9;356(9233):930-3.

Sharma S, Sharma SK, Mohan A, Wadhwa J, Dar L, Thakur S, et al. Clinical profile of dengue hemorrhagic fever in adults during 1996 outbreak in Delhi, India. Dengue Bull. 1998;22:20-30.

Bhattacharjee B, Bhattacharya S, Majumdar D, Chakraborty S, Sardar B et al. An Observational Study on Clinical, Epidemiological and Laboratory Profile in Patients of Dengue Fever Admitted to a Tertiary Care Hospital in Kolkata, West Bengal, India in the Year 2016. J Microbiol Exp. 2017:5(5):00161.

van Gorp EC, Suharti C, Mairuhu AT, Dolmans WM, van der Ven J, Demacker PN, et al. Changes in the plasma lipid profile as a potential predictor of clinical outcome in dengue hemorrhagic fever. Clin Inf Dis. 2002 Apr 15;34(8):1150-3.

Souza LJ, Nogueira RM, Soares LC, Soares CE, Ribas BF, Alves FP, et al. The impact of dengue on liver function as evaluated by aminotransferase levels. Bra J Inf Dis. 2007 Aug;11(4):407-10.

Laoprasopwattana K, Tangcheewawatthanakul C, Tunyapanit W, Sangthong R. Is zinc concentration in toxic phase plasma related to dengue severity and level of transaminases?. PLoS Neg Trop Dis. 2013 Jun 20;7(6):e2287.

Koraka P, Lim YP, Shin MD, Setiati TE, Mairuhu AT, van Gorp EC, et al. Plasma levels of inter-α inhibitor proteins in children with acute dengue virus infection. PLoS One. 2010 Apr 6;5(4):e9967.

Chaturvedi UC, Nagar R. Nitric oxide in dengue and dengue haemorrhagic fever: necessity or nuisance?. FEMS Immunol Med Microbiol. 2009 Jun 1;56(1):9-24.

Valero N, Espina LM, Añez G, Torres E, Mosquera JA. increased level of serum nitric oxide in patients with dengue. Ame J Trop Med Hyg. 2002 Jun 1;66(6):762-4.

Hober D, Poli L, Roblin B, Gestas P, Chungue E, Granic G, et al. Serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β) in dengue-infected patients. Ame J Trop Med Hyg. 1993 Mar 1;48(3):324-31.

van Gorp EC, Suharti C, Mairuhu AT, Dolmans WM, van der Ven J, Demacker PN, et al. Changes in the plasma lipid profile as a potential predictor of clinical outcome in dengue hemorrhagic fever. Clin Inf Dis. 2002 Apr 15;34(8):1150-3.

Dunham C, Fealk MH, Sever WE. Following severe injury, hypocholesterolemia improves with convalescence but persists with organ failure or onset of infection. Crit Care. 2003 Dec;7(6):R145.

Cui L, Lee YH, Kumar Y, Xu F, Lu K, Ooi EE, et al. Serum metabolome and lipidome changes in adult patients with primary dengue infection. PLoS neg Trop Dis. 2013 Aug 15;7(8):e2373.

Sidrah Lodhi, Quratul Ain Tahira, Sajid Abaidullah :Hypocholesterolemia As A Predictor Of Disease Severity In Dengue Fever, annal. 2014, 20 (4), 335-40.

Kumar NS, Kalaivanam KN, Ramadas D. Hepatic Proteins & Protein Oxidation-Role in Dengue Fever. Int J Biotechnol Bio. 2016;12(2):161-5.

Nema S, Deol A, Tripathi K, Ramnani VK. Seroepidemiology and Gender Related Differences in Laboratory Characteristics of Dengue Virus Infection: A Hospital Based Study, Bhopal. IOSR J Dental Medi Sci. 2017;16(1):95-9.

Ray G, Kumar V, Kapoor AK, Dutta AK, Batra S. Status of antioxidants and other biochemical abnormalities in children with dengue fever. J Trop Pediatr. 1999 Feb 1;45(1):4-7.

Agarwal R, Kapoor S, Nagar R, Misra A, Tandon R, Mathur A, et al. A clinical study of the patients with dengue hemorrhagic fever during the epidemic of 1996 at Lucknow, India. Southeast Asian J Trop Med Pub Health. 1999 Dec;30(4):735-40.

Wali JP, Biswas A, Handa R, Aggarwal P, Wig N, Dwivedi SN. Dengue haemorrhagic fever in adults: a prospective study of 110 cases. Trop Doctor. 1999 Jan;29(1):27-30.

Eong OE. Changing pattern of dengue transmission in Singapore. Dengue Bulletin, 2001, 25:40-44. Available at: http://apps.searo.who.int/PDOS_DCS/B0223.pdf. Accessed on 2nd February 2001.

Yew YW, Ye T, Ang LW, Ng LC, Yap G, James L, et al. Seroepidemiology of dengue virus infection among adults in Singapore. Ann Acad Med Singapore. 2009 Aug 1;38(8):667-75.

Ray G, Kumar V, Kapoor AK, Dutta AK, Batra S. Status of antioxidants and other biochemical abnormalities in children with dengue fever. J Trop Pediatr. 1999 Feb 1;45(1):4-7.

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Published

2019-12-24

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Original Research Articles