Differential platelet receptor expression for viral capture (DC-SIGN) and plasma leakage in patients with dengue infection

Here we are presenting a case of dengue fever presented with an atypical symptom of “oculogyric crisis” with features of multi organ dysfunction syndrome. Increased vascular permeability, plasma leakage, haemorrhagic manifestations, and thrombocytopenia are charecteristics of dengue fever. A 19 year old male patient, with no co-morbidity came to Dhiraj hospital with chief complaints of fever which was high grade & intermittent, it is associated with chills & rigours for 5 days. Also complain of abdominal pain over epigastric region, dull aching non radiating associated with decreased appetite since 5 days. Dengue infection has a wide range of clinical features. Neurological complications can occur in any spectrum of dengue infection. The diagnosis of oculogyric crisis is majorly clinical and it requires a focused detailed history and detailed physical examination to find out possible triggers for the crisis and to rule out other reasons for abnormal eye movements.

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The association of lipopolysaccharide and inflammatory markers with severe dengue infection

10.21203/rs.2.19143/v1 ◽

2019 ◽

Author(s):

N.L Ajantha Shyamali ◽

Sameera D. Mahaputuna ◽

Laksiri Gomes ◽

Ananda Wijewickrama ◽

Graham Ogg ◽

...

Keyword(s):

Inflammatory Markers ◽

Metabolic Diseases ◽

Dengue Infection ◽

Severe Dengue ◽

Atopic Diseases ◽

Disease Pathogenesis ◽

Critical Phase ◽

Plasma Leakage ◽

Detectable Serum

Abstract Background Although serum lipopolysaccharide (LPS) was shown to associate with development of severe dengue, the reasons for high LPS and its subsequent involvement in disease pathogenesis are not known. Methods: We assessed LPS, lipopolysaccharide binding protein (LBP), CRP, IL-18, procalcitonin in patients with acute dengue fever (DF=129) and dengue haemorrhagic fever (DHF=64) and correlated these observations with the presence of comorbid illnesses, concurrent bacteraemia and clinical disease severity. Results: LPS levels were significantly (p=0.01) higher in patients with DHF, compared to those with DF. 45 (70%) of those with DHF and 63 (49%) of those with DF had detectable LPS and therefore, presence of LPS was significantly associated with DHF (p=0.005, OR=2.48, 95% CI: 1.29 to 4.64). Those with metabolic diseases, 22/29 (75.9%) and those with atopic diseases 17/22 (77.3%) were significantly more likely to have detectable LPS (p=0.025, OR=2.9, 95% CI- 1.17 to 7.59) and (p=0.039, OR=3.06, 95% CI-1.07 to 7.81) respectively, than others. LPS, LBP and CRP levels were high at the febrile phase, before onset of plasma leakage and reduced towards to the critical phase. The CRP levels were significantly higher (p=0.03) in early illness (≤3 days of illness) in those who progressed to develop DHF when compared to those who developed DF. Those who had detectable serum LPS also had a significantly higher CRP (p=0.01). Although there was no difference in procalcitonin (PCT) levels in patients with DF and DHF, the PCT levels were significantly higher in those who had detectable serum LPS (p=0.02). Conclusions: LPS levels were higher in patients with DHF and associated with high levels of other inflammatory markers. Since LPS levels were highest during early infection and were significantly more likely to be present in those with comorbid illnesses, the possible role of LPS in disease pathogenesis, should be further investigated.

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Dengue fever complicated with acute liver failure: A case report of expanded dengue syndrome and literature review

SAGE Open Medical Case Reports ◽

10.1177/2050313x20913428 ◽

2020 ◽

Vol 8 ◽

pp. 2050313X2091342 ◽

Cited By ~ 1

Author(s):

Navaneethakrishnan Suganthan ◽

Gajawathana Sakthilingham ◽

Thirunavukarasu Kumanan

Keyword(s):

Liver Failure ◽

Acute Liver Failure ◽

Dengue Fever ◽

Dengue Infection ◽

Dengue Shock Syndrome ◽

Acute Hepatic Failure ◽

Fresh Frozen Plasma ◽

Uneventful Recovery ◽

Fresh Frozen ◽

Plasma Leakage

Dengue is the most common arboviral disease, the presentation of which ranges from asymptomatic illness to dengue shock syndrome. Liver is the most common organ affected in dengue, and liver involvement is asymptomatic in majority. Dengue fever is a rare, but a leading cause for acute liver failure in endemic regions. Here, we report a case of a 34-year-old male ethanol user (16 units per week), presented with typical features of dengue infection, which was confirmed serologically, complicated with acute liver failure without clinical, radiological or laboratory evidence of plasma leakage. He was managed with intravenous fresh frozen plasma and N-acetyl cysteine along with other recommended supportive therapies for acute hepatic failure. He made an uneventful recovery.

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CFD CHARACTERIZATION OF FLOW PATTERN AROUND ENDOTHELIAL CELL IN DENGUE INFECTION WITH PLASMA LEAKAGE

Jurnal Teknologi ◽

10.11113/jt.v76.5709 ◽

2015 ◽

Vol 76 (7) ◽

Author(s):

Nur Kaliwantoro ◽

Marsetyawan HNE Soesatyo ◽

Indarto Indarto ◽

Mohammad Juffrie ◽

Rini Dharmastiti ◽

...

Keyword(s):

Shear Stress ◽

Endothelial Cell ◽

Dengue Virus ◽

Fluid Dynamic ◽

Dengue Infection ◽

Leading Edge ◽

Cell Junction ◽

Computational Domain ◽

Permeable Membrane ◽

Plasma Leakage

Plasma leakage is the pathological hall mark in dengue infection and may cause fatal condition to the patients. In this paper, the CFD (computational fluid dynamic) model is adopted to characterize the flow on the endothelial cells surface with plasma leakage based on in vitro experiments of HUVEC (human umbilical vein endothelial cell) culture on the permeable membrane. The computational domain used is a simplified model of single cell. At the leading edge of the domain and among the membranes, the gaps are modeled as a representation of cell-cell junction breakdown caused by dengue virus infection. The result shows that at the leading edge , the fluid starts to move more quickly and increases to the maximum value at the middle of the cell and then drops to zero at the trailing edge. From the physical point of view, this result describes that there is a variation of the values of the wall shear stress due to the velocity gradient. These results can be considered as a first step to develop the ways of the prevention of the dengue infection through manipulation the shear stress to reduce the potency of dengue virus to attach the cell surface.

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Carica papaya extract in dengue: a systematic review and meta-analysis

BMC Complementary and Alternative Medicine ◽

10.1186/s12906-019-2678-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Senaka Rajapakse ◽

Nipun Lakshitha de Silva ◽

Praveen Weeratunga ◽

Chaturaka Rodrigo ◽

Chathurani Sigera ◽

...

Keyword(s):

Systematic Review ◽

Clinical Trials ◽

Confidence Interval ◽

Carica Papaya ◽

Meta Analysis ◽

Dengue Infection ◽

Platelet Counts ◽

Duration Of Hospital Stay ◽

Plasma Leakage ◽

Quality Evidence

Abstract Background Carica papaya (CP) extract is becoming popular as an unlicensed herbal remedy purported to hasten recovery in dengue infection, mostly based on observations that it may increase platelet counts. This systematic review and meta-analysis aims to critically analyze the evidence from controlled clinical trials on the efficacy and safety of CP extract in the treatment of dengue infection. Methods PubMed, LILACS and Google Scholar were searched for randomized or non-randomized trials enrolling patients with suspected or confirmed dengue where CP extract was compared, as a treatment measure, against standard treatment. Recovery of platelet counts as well as other clinical indicators of favourable outcome (duration of hospital stay, prevention of plasma leakage, life threatening complications, and mortality) were assessed. Results Nine studies (India-6, Pakistan-1, Indonesia-1, Malaysia-1) met the inclusion criteria. Seven studies showed an increase in platelet counts in patients receiving CP extract, while one study showed no significant difference between the two groups, and direct comparison was not possible in the remaining study. Serious adverse events were not reported. CP extract may reduce the duration of hospital stay (mean difference − 1.98 days, 95% confidence interval − 1.83 to − 2.12, 3 studies, 580 participants, low quality evidence), and cause improvement in mean platelet counts between the first and fifth day of treatment (mean difference 35.45, 95% confidence interval 23.74 to 47.15, 3 studies, 129 participants, low quality evidence). No evidence was available regarding other clinical outcomes. Conclusions The clinical value of improvement in platelet count or early discharge is unclear in the absence of more robust indicators of favourable clinical outcome. Current evidence is insufficient to comment on the role of CP extract in dengue. There is a need for further well designed clinical trials examining the effect of CP on platelet counts, plasma leakage, other serious manifestations of dengue, and mortality, with clearly defined outcome measures.

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Analysis of Platelet Receptor Expression in ITP,

Blood ◽

10.1182/blood.v118.21.3289.3289 ◽

2011 ◽

Vol 118 (21) ◽

pp. 3289-3289

Author(s):

Jianlin Qiao ◽

Huy Tran ◽

Fi-Tjen Mu ◽

Robert K Andrews ◽

Elizabeth E Gardiner

Keyword(s):

Platelet Count ◽

Conflicts Of Interest ◽

Surface Expression ◽

Experimental Models ◽

Receptor Expression ◽

Response To Treatment ◽

Platelet Surface ◽

Healthy Donors ◽

Platelet Receptor ◽

Von Willebrand

Abstract Abstract 3289 In this study we assess platelet receptor expression and shedding in patients with immune thrombocytopenia (ITP) before and during treatment. The aim is to evaluate the potential value of quantitative measurement of platelet receptors for diagnosis and/or monitoring treatment in thrombocytopenia due to immune or other causes. The platelet-specific collagen receptor, glycoprotein (GP)VI, is associated with the Fc receptor γ-chain (FcRγ). GPVI/FcRγ is coassociated on platelet surface with the GPIb-IX-V complex; GPIbα of GPIb-IX-V binds von Willebrand factor and other ligands. Our previous studies showed engagement of platelet FcγRIIa by antiplatelet antibodies induced ectodomain shedding of GPVI, generating soluble ectodomain (sGPVI) in plasma. However, apart from one individual with an anti-GPVI antibody, whether anti-platelet antibodies associated with ITP affect GPVI/GPIb expression/shedding has not been addressed. In this study we used flow cytometry and a sGPVI ELISA to assess 1) whether patients with ITP had dysregulated expression/shedding of GPVI or GPIbα, and 2) whether platelet receptor expression changes prior to recovery of platelet count in individuals undergoing treatment for ITP. In 9 ITP patients (mean age=48.6, range 29–79; 6 female) with platelet count 61±9 × 109/L (range, 33–122 × 109/L), GPVI surface expression (GeoMean±SE, 137±17) was lower than healthy controls (274±26; n=17; platelet count 247±13), and sGPVI in patient plasma was significantly higher (39±4 ng/mL) compared to 17 healthy donors (19±3 ng/mL) (P=0.0006). In longitudinal samples analysed at weekly intervals during 2-month treatment with steroids, decreased GPVI surface expression and increased sGPVI in plasma remained essentially unchanged as the platelet count normalized, consistent with persistent anti-platelet antibody. However, while levels of intact platelet GPIbα were significantly reduced in ITP compared to healthy donors (P=0.0053), they approached healthy levels within 1 week of treatment, preceding improvement in platelet count or other measures. GPIbα expression/cleavage has been previously implicated in platelet clearance in experimental models, and our analysis suggests the proteolytic status of human GPIbα may be a novel early marker for evaluating response to treatment in ITP. Disclosures: No relevant conflicts of interest to declare.

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Shock Prognostic Factors in Hospitalized Dengue Hemorrhagic Fever Children

Advanced Science Letters ◽

10.1166/asl.2018.12692 ◽

2018 ◽

Vol 24 (8) ◽

pp. 6221-6224

Author(s):

Hindra Irawan Satari ◽

Rossy Agus Mardani ◽

Hartono Gunardi

Keyword(s):

Prognostic Factors ◽

Dengue Hemorrhagic Fever ◽

Dengue Infection ◽

Clinical Manifestations ◽

Dengue Shock Syndrome ◽

Hemorrhagic Fever ◽

Health Department ◽

Abdominal Tenderness ◽

Diverse Area ◽

Plasma Leakage

Various clinical manifestations, complex pathogenesis and different virus serotypes in diverse area make us difficult to predict course of disease, even the child admitted in early. Prognostic factors are very important to predict cases progressing to become DSS. Dengue shock syndrome (DSS) occurs in 15.53% of Dengue hemorrhagic fever (DHF) patients with 7.81% mortality rate. Aim: To explore the prognostic factors of shock in hospitalized DHF children regarding the new 2011 WHO dengue virus infection classification guideline. This was a retrospective study using medical records of children age below 18 years old with WHO fulfilled grade 1 and 2 DHF diagnosis from January 2013–December 2016 in Child Health Department of Dr. Cipto Mangunkusumo Hospital, Jakarta. Independent variables were sex, age, nutritional status, secondary dengue infection, leucopenia, abdominal tenderness, gastrointestinal bleeding, hepatomegaly and plasma leakage. Shock was dependent variable. Multivariate analysis was done by using logistic regresion analysis. There were 98 DHF subjects, 5 subjects became DSS during hospitalization. DSS subject characteristics were age of >5 years old, female, malnutrition, abdominal tenderness, hemoconcentration ≥20%, secondary dengue infection, leucocyte ≥5.000 mm3 and thrombocyte <50.000 mm3. Multivaryate analysis showed malnutrition and hepatomegaly were prognosis factors of DSS. Malnutrition and hepatomegaly were prognotic factors of dengue shock syndrome. Clinicians should be more aware with these factors when managed hospitalized DHF patients.

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Olive Oil-Based Lipid Emulsions Do Not Influence Platelet Receptor Expression in Comparison to Medium and Long Chain Triglycerides In vitro

Lipids ◽

10.1007/s11745-016-4182-5 ◽

2016 ◽

Vol 51 (11) ◽

pp. 1241-1248 ◽

Cited By ~ 1

Author(s):

Carsten Stoetzer ◽

Katja Nickel ◽

Annette Weißig ◽

Marieke Großheim ◽

Dirk Scheinichen ◽

...

Keyword(s):

Olive Oil ◽

Receptor Expression ◽

Lipid Emulsions ◽

Platelet Receptor ◽

Long Chain Triglycerides ◽

Long Chain

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Dengue Infection: Frequently Asked Questions by People in the Province of Aklan, Philippines

Journal of Clinical and Laboratory Research ◽

10.31579/2768-0487/032 ◽

2021 ◽

Vol 3 (2) ◽

pp. 01-15

Author(s):

Makarius Tel Aviv C. Dela Cru ◽

Benie T. Constantino IH

Keyword(s):

Dengue Infection ◽

Febrile Illness ◽

Viral Disease ◽

Effective Vaccine ◽

Global Public Health ◽

Serological Detection ◽

Public Health Services ◽

Denv Serotypes ◽

Life Threatening ◽

Plasma Leakage

Dengue virus is the most common mosquito borne viral disease in humans, and poses a major challenge to global public health services. Infection can be caused by any of the 4 DENV serotypes, transmitted by female Aedes aegypti mosquitoes. Presenting features may vary from a mild self-limiting febrile illness to life-threatening symptoms of bleeding, organ impairment, and plasma leakage leading to shock. Early diagnosis and monitoring are critical to reduce mortality, especially in the context of the COVID-19 pandemic. Laboratory tests, such as the serological detection of either antigen or antibodies are useful in the diagnosis. Currently, although a vaccine for DENV is available, it remains a challenge to develop an effective vaccine against 4 discrete serotypes and antiviral drugs effective in reducing morbidity or improving disease outcome.

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Serotype Infectivity and Phylogenetic of Dengue Virus cause of Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF), and Dengue Shock Syndrome (DSS) in Surabaya- Indonesia

Journal of Stem Cell Research and Tissue Engineering ◽

10.20473/jscrte.v4i1.21588 ◽

2020 ◽

Vol 4 (1) ◽

pp. 1

Author(s):

Fedik Rantam

Keyword(s):

Phylogenetic Analysis ◽

Nucleotide Sequence ◽

Dengue Virus ◽

Dengue Infection ◽

Dengue Shock Syndrome ◽

Hemorrhagic Fever ◽

Rt Pcr ◽

Who Criteria ◽

Plasma Leakage ◽

Degree Of Severity

Infection with DENV causes a spectrum of clinical disease ranging. The aim of this study is to investigate the infectivity of DENV with degree of severity dengue infection in Surabaya. Dengue infection was established by IgM anti dengue, and two step multiplex RT PCR and Nucleotide sequence. Grading of degree severity infection follow the WHO criteria 2011. DSS cases found 3 from 36 patients caused by DENV 2. The most uninfective was DENV 1, and the most prevalence dengue infection caused by DENV 3. The infectivity of dengue infection shown 16 patients lead to severity with plasma leakage. All of sera patients detecting using multiplex RT-PCR were positive, but it were analyzed using Duo ELISA only 22 serum sera positive IgM and IgG from 36 sera. . The Phylogenetic analysis indicates that the isolates from 2011 to 2012 close related with dengue isolate from 1998 and belong to 2009 to 2020.In this study it indicates that DENV 2 predominantly is the cause of DSS.

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