HUBUNGAN TROMBOSITOPENIA DAN HEMATOKRIT DENGAN MANIFESTASI PERDARAHAN PADA PENDERITA DEMAM DENGUE  DAN DEMAM BERDARAH DENGUE

Abstract: Dengue fever (DF) and dengue haemorrhagic fever (DHF), an infection disease who still become a health problem in Indonesia. There was increasing cases reported in Indonesia from 2011 to 2012. Thrombocytopenia and plasma leakage signed by haemoconcentration are important indicator in dengue. Bleeding manifestation appears as clinical symptom of DF and DHF that increases mortality ratio of dengue infection. The aim of this study is toinvestigatethe correlation of thrombocytopenia and hematocrit tobleeding manifestation of dengue fever and dengue haemorrhagic fever.This study is retrospective cross-sectional. Forty two men and thirty five women were evaluated in this study, fifty nine of them were diagnosedas DF and eighteen of them were diagnosed asDHF. The correlation of thrombocytes to hematocrit used nonparametric Spearman test, the result were significant with p=0,000 and r=-0,183. The correlation of thrombocytes to the occurrence of bleeding manifestation and hematocrit to the occurrence of bleeding manifestation, both were not significant, with p=0,714 and p=0,153. This study suggest that there were a very weak correlation between thrombocytes and hematocrit and no correlation between thrombocytopenia and hematocrit with bleeding manifestation. Keywords: Dengue Fever, Dengue Haemorrhagic Fever, Thrombocytopenia, Hematocrit, and Bleeding Manifestation. Abstrak: Demam dengue (DD) dan demam berdarah dengue (DBD) merupakan penyakit infeksi yang masih menjadi masalah kesehatan di Indonesia. Telah dilaporkan terdapat peningkatan jumlah kasus di Indonesiadari tahun 2011 ke tahun 2012. Berdasarkan kriteria laboratorium WHO, jumlah trombosit yang rendah (trombositopenia) dan kebocoran plasma yang ditandai dengan hemokosentrasi merupakan indikator penting pada DD dan DBD. Gejala klinis DD dan DBD dapat disertai dengan manifestasi perdarahan yang akan meningkatkan rasio mortalitas penderita infeksi dengue. Penelitian yang bertujuan untuk mengetahui hubungan trombositopenia dan hematokrit dengan manifestasi perdarahan pada penderita demam dengue dan demam berdarah dengue ini menggunakanmetode retrospektif dengan studi cross-sectional.Sampel pada penelitian ini terdiri dari 42 orang laki-laki dan 35 orang perempuan. Penderita DD berjumlah 59 orang dan penderita DBD berjumlah 18 orang. Uji nonparametrik Spearman terhadap trombosit dan hematokrit mendapat hasil signifikan (p=0,000 ; r=-0,183). Uji nonparametrik Spearman terhadap trombosit dan manifestasi perdarahan mendapat hasil yang tidak signifikan (p=0,714). Uji nonparametrik Spearman terhadap hematokrit dan manifestasi perdarahan mendapat hasil yang tidak signifikan (p=0,153). Dapat disimpulkan bahwa terdapat korelasi yang sangat lemah antara trombosit dan hematokrit, tidak terdapat hubungan yang bermakna antara trombositopenia dan hematokrit dengan manifestasi perdarahan. Kata kunci:Demam Dengue, Demam Berdarah Dengue, Trombositopenia, Hematokrit, dan Manifestasi Perdarahan.

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Clinical Profile of Dengue Fever in Children

Bangladesh Journal of Child Health ◽

10.3329/bjch.v33i2.5678 ◽

1970 ◽

Vol 33 (2) ◽

pp. 55-58 ◽

Cited By ~ 2

Author(s):

ABM Shahidul Alam ◽

S Anwar Sadat ◽

Zakaria Swapan ◽

Aftab U Ahmed ◽

Md Nazmul Karim ◽

...

Keyword(s):

Abdominal Pain ◽

Dengue Fever ◽

Dengue Infection ◽

Cross Sectional Study ◽

Dengue Haemorrhagic Fever ◽

Published Data ◽

Haemorrhagic Fever ◽

Cross Sectional ◽

Normal Platelet ◽

The Mean

Background: Dengue infection has become endemic in Bangladesh since it hasbeen broken out in June 2000. Although children are the usual victim of dengueinfection, there is paucity of published data regarding dengue infection in children inour country.Objectives: This study was designed to document the presenting features and outcomeof Dengue infection in children.Materials and Methods: This cross sectional study was done among the childrenhaving Dengue infection. Fifty four consecutive patients were enrolled. Purposivesampling was done. In every patient a detailed history was taken. Clinical examinationsand relevant investigations were done. Data were collected in a predesigned structuredquestionnaire. Data were analyzed with the help of descriptive statistics and Chisquare(x2) Test.Results: The mean age of the patients was 6.5±3.5 years with equal male and femaleratio. Among 54 patients, 40.7% presented with dengue fever (DF), the rest (59.3%)presented with dengue haemorrhagic fever (DHF). Most of the patients presented withhigh grade continued type of fever (75.9%), followed by abdominal pain (59.3%),vomiting (57.4%). Itchy rash and fever were the most important characteristic signs(75.9% each). Flushed appearance observed in 68.4% and 59.3% patients showedbleeding manifestation of which sub-conjunctival haemorrage was the commonestform (33.3%). Leucopenia were present in only 9.3% of the patients. Platelet countless than 100×109/L were found in 68.5% patients. Tourniquet test was positive in31.5% of cases. All of the patients had packed cell volume (PCV) less than 45%.Raised serum alanine aminotransferase (ALT) was observed in 40.7% of children.IgM and/or IgG antibodies for dengue virus were positive in 96.29% patients. Majority(94%) of the patients completely recovered from the disease and only 6% died.Conclusion: High grade continued fever, vomiting with abdominal pain and itchy skinrash (with normal platelet count) were the presenting features. Commonest form ofbleeding manifestation was subconjunctival haemorrhage. Bleeding manifestationhad a significant association with the degree of thrombocytopenia but no corelationwas observed with tourniquet test positivity.Key words: Dengue fever (DF); dengue haemorrhagic fever (DHF); paediatric.DOI: 10.3329/bjch.v33i2.5678Bangladesh Journal of Child Health 2009; Vol.33(2): 55-58

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Effect of Prior Symptomatic Dengue Infection on Dengue Haemorrhagic Fever (DHF) in Children

Journal of Tropical Medicine ◽

10.1155/2021/8842799 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Randula Ranawaka ◽

Chamara Jayamanne ◽

Kavinda Dayasiri ◽

Dinuka Samaranayake ◽

Udara Sandakelum ◽

...

Keyword(s):

Dengue Fever ◽

Past History ◽

Secondary Infection ◽

Severe Disease ◽

Dengue Infection ◽

Dengue Shock Syndrome ◽

Dengue Haemorrhagic Fever ◽

Severe Dengue ◽

Haemorrhagic Fever ◽

History Of

Pathogenesis of dengue haemorrhagic fever is not fully understood, but it is thought that there is antibody enhancement during the secondary infection, which causes severe dengue haemorrhagic fever (DHF). Therefore, patients who have DHF should have a documented history of symptomatic dengue infection in the past. A retrospective descriptive-analytical study was conducted at the University Paediatric Unit at Lady Ridgeway Hospital for Children, Colombo, Sri Lanka. All children who had fulfilled the criteria for DHF admitted to the unit from April 2018 to September 2018 were recruited into the study. Relevant data were collected from bed head tickets. One hundred and eighty-four children were included in the final analysis. Thirty-three (17.9%) had a past history of documented symptomatic dengue infection, while 82.1% did not have a documented dengue infection. Twelve patients had dengue shock syndrome, and none of them had previously documented symptomatic dengue fever. Dextran was used in 96 patients in the critical phase. Twelve (42%) patients with past documented symptomatic dengue fever needed dextran while 84 (54.9%) patients without a documented past history of dengue fever needed dextran. In our clinical observation, we noticed that children with DHF mostly did not have a documented symptomatic prior dengue infection, while those with a documented symptomatic prior infection had a milder subsequent illness. In fact, the majority (82.1%) of patients with DHF did not have documented previous symptomatic dengue infection. It was also observed that the clinical course of subsequent dengue infection was less severe in patients with previously documented symptomatic dengue fever. This finding should be further evaluated in a larger scale study minimizing the all-confounding factors. This fact is more important in selecting recipients for vaccines against the dengue virus, which are supposed to produce immunity against the virus without causing the severe disease.

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Headache Features in Patients with Dengue Virus Infection

Cephalalgia ◽

10.1111/j.1468-2982.2006.01100.x ◽

2006 ◽

Vol 26 (7) ◽

pp. 879-882 ◽

Cited By ~ 10

Author(s):

RB Domingues ◽

GW Kuster ◽

FL Onuki de Castro ◽

VA Souza ◽

JE Levi ◽

...

Keyword(s):

Virus Infection ◽

Dengue Virus ◽

Dengue Fever ◽

Dengue Infection ◽

Severe Form ◽

Dengue Haemorrhagic Fever ◽

Neurological Involvement ◽

Haemorrhagic Fever ◽

Dengue Virus Infection

The aim of this study was to describe the frequency and features of headache among patients with confirmed dengue virus infection and to compare the headache features in patients with dengue fever and dengue haemorrhagic fever, primary and secondary dengue infection, and patients with and without neurological involvement. Patients with classic dengue fever had a more intense headache than those with the more severe form of the disease, dengue haemorrhagic fever.

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Liver Function Derangement and Bleeding Morbidity in Dengue Fever and Dengue Haemorrhagic Fever in a tertiary Hospital in Bangladesh

Bangladesh Journal of Medicine ◽

10.3329/bjm.v33i1.56789 ◽

2021 ◽

Vol 33 (1) ◽

pp. 44-51

Author(s):

Md Arifuzzaman ◽

- Amiruzzaman ◽

Md Saddam Hossain ◽

Naylla Islam ◽

Abdullah Al Noman ◽

...

Keyword(s):

Dengue Fever ◽

Liver Dysfunction ◽

Severe Disease ◽

Dengue Infection ◽

Dengue Haemorrhagic Fever ◽

Health Concern ◽

P Value ◽

Haemorrhagic Fever ◽

Female Ratio ◽

Study Results

Background: Dengue is a major international health concern that is prevalent in tropical and sub tropical countries. Study of dengue infection and its Liver complications are scarce from countries like India. This study was done to assess the frequency and spectrum of liver dysfunction and bleeding morbidity in Dengue infection patients. Methods: A Cross sectional prospective observational study was performed in the of Department of Medicine Sir Salimullah Medical College Mitford Hospital. All the inpatients who were diagnosed with dengue infection between July 2015 to July 2016 were included in this study. A total of 70 patients were included in the study. Results: Patients were classified as classical dengue fever (DF) 61.5.% dengue haemorrhagic fever (DHF) 38.5%. The mean age was 28.607±10.45 years in DF group and 26.78±11.78 years in DHF group and male: female ratio was 3:1. Deranged serum glutamic-oxaloacetic transaminase (SGOT) and/or Serum glutamic pyruvic transaminase (SGPT) was present in most of the patients. Elevation of ALT level occured more in DHF group patient (81%) than DF group (46%). Out of 70 patient 28(40%) patient were within normal value. 42 (60%) patient had elevated ALT level which is statistically significant (p value-<0.05)..The degree of rise of SGOT, SGPT,and Bilirubin was significantly more in DHF and DSS, as compared to DF. About bleeding morbidity, purpura was a mentionable finding 29(41%) but gum bleeding 15(21%), echymosis 14(20%), are less in both DF and DHF group. Major bleeding like hematomesis 5 (7%), melaena 4 (5%) and haematuria 1 (1%) also occured in both group of patients. Conclusion: Liver dysfunction in the form of raised SGPT was seen in almost all patients. Preferentially high SGOT may serve as an early indicator of dengue infection while high values of bilirubin, SGOT, SGPT,may be an indicator of severe disease and poor prognosis. Bangladesh J Medicine July 2022; 33(1) : 44-51

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Dengue fever and dengue haemorrhagic fever in adolescents and adults

Paediatrics and International Child Health ◽

10.1179/2046904712z.00000000049 ◽

2012 ◽

Vol 32 (sup1) ◽

pp. 22-27 ◽

Cited By ~ 22

Author(s):

Terapong Tantawichien

Keyword(s):

Dengue Fever ◽

Dengue Haemorrhagic Fever ◽

Haemorrhagic Fever ◽

Adolescents And Adults

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NS 1 lasts longer than the dengue virus nucleic acid in the clinically suspected patients with dengue fever and dengue haemorrhagic fever

VirusDisease ◽

10.1007/s13337-017-0401-9 ◽

2017 ◽

Vol 28 (3) ◽

pp. 341-344 ◽

Cited By ~ 2

Author(s):

Nadeera Sirisena ◽

Faseeha Noordeen ◽

LakKumar Fernando

Keyword(s):

Nucleic Acid ◽

Dengue Virus ◽

Dengue Fever ◽

Dengue Haemorrhagic Fever ◽

Haemorrhagic Fever

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Epidemiological and Clinical Features of Dengue Infection in Adults in the 2017 Outbreak in Vietnam

BioMed Research International ◽

10.1155/2019/3085827 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Bui Vu Huy ◽

Le Nguyen Minh Hoa ◽

Dang Thi Thuy ◽

Nguyen Van Kinh ◽

Ta Thi Dieu Ngan ◽

...

Keyword(s):

Elderly Patients ◽

Dengue Fever ◽

Clinical Features ◽

Dengue Infection ◽

Clinical Manifestations ◽

Warning Signs ◽

Severe Dengue ◽

Severe Bleeding ◽

Cross Sectional ◽

Number Of Patients

Purpose. The clinical features and laboratory results of dengue-infected adult patients admitted to the hospital during the 2017 outbreak were analyzed in this study. Method. This is a cross-sectional study. 2922 patients aged 18 years or more with dengue fever in National Hospital for Tropical Diseases (NHTD) in the North and Hospital for Tropical Disease (HTD) in the South of Vietnam were recruited in this study. Result. Patients were admitted in the hospital around the year and concentrated from August to December, in 53/63 (84.0%) provinces in Vietnam, and patients in all ages were affected. The number of patients with dengue fever was 1675 (57.3%), dengue with warning signs 914 (31.3%), and severe dengue 333 (11.4%), respectively. Among patients with severe dengue, severe plasma leakage and dengue shock account for 238 (8.1%), severe organ impairment 73 (2.5%), and severe bleeding 22 (0.75%). The rate of mortality was 0.8%, and the outcome of dengue patients is worse in the elderly and people with underlying diseases. Conclusion. The 2017 dengue outbreak occurred in a larger scale than in the previous years in terms of time, location, and number of patients. More elderly patients were infected by dengue in this outbreak, and this may contribute to the mortality rate. Clinical manifestations of dengue patients in Southern Vietnam are more typical than the northern, but the rate of severe dengue is not different. The mortality risk and underlying conditions associated with dengue-infected elderly patients are worthy of further investigations in the future.

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Role of T cells, cytokines and antibody in dengue fever and dengue haemorrhagic fever

Reviews in Medical Virology ◽

10.1002/rmv.507 ◽

2006 ◽

Vol 16 (4) ◽

pp. 263-275 ◽

Cited By ~ 73

Author(s):

Joshua Fink ◽

Feng Gu ◽

Subhash G. Vasudevan

Keyword(s):

T Cells ◽

Dengue Fever ◽

Dengue Haemorrhagic Fever ◽

Haemorrhagic Fever

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Quantitative NS1 antigen and the severity of dengue virus infections

Paediatrica Indonesiana ◽

10.14238/pi55.2.2015.87-90 ◽

2015 ◽

Vol 55 (2) ◽

pp. 87

Author(s):

Ni Made Adi Purnami ◽

Mohammad Juffrie ◽

Made Gde Dwi Lingga Utama

Keyword(s):

Clinical Course ◽

Nonstructural Protein ◽

Dengue Infection ◽

Hemorrhagic Fever ◽

Cross Sectional Study ◽

Severe Dengue ◽

Virus Infections ◽

Cross Sectional ◽

Nonstructural Protein 1 ◽

Spearman Test

Background Dengue infection is one of the main cause ofmorbidity and mortality in children in Indonesia. Since it is knownthat earlier treatment and supportive therapies can decreased casefatality rate from dengue hemorrhagic fever (DHF), identificationof children who have risks to develop to DHF must be quicklyidentified, mainly in areas of endemic.Objective To find a correlation between increased quantitativesecreted nonstructural protein-1 (sNS1) with clinical course ofsevere dengue infections.Methods This was a cross-sectional study conducted on childrenwith dengue infections in Tropical Infections Division of ChildHealth Department, Sanglah Hospital, Denpasar. Detection ofthe dengue antigen was made by examining sNS1 quantitativeimmuno-assay. Analysis correlation of Spearman test was used tolook the relationship between increased quantitative sNS1 withclinical course of severe dengue infections.Results There was a positive relationship between quantitativesNS1 and clinical course of severe dengue infections with a valueof r = 0.903, P=0.001. Increased sNS1 level had a positivecorrelation with more severe dengue infections.Conclusions Quantitative sNS1 titer has a strong positivecorrelation with clinical course of severe dengue infections.

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