Publication: Laboratory predictors of dengue shock syndrome during the febrile stage
3
Issued Date
2010-03-01
Resource Type
ISSN
01251562
Other identifier(s)
2-s2.0-77956018135
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Mahidol University
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SCOPUS
Bibliographic Citation
Southeast Asian Journal of Tropical Medicine and Public Health. Vol.41, No.2 (2010), 326-332
Suggested Citation
Ampaiwan Chuansumrit, Chartchai Puripokai, Punnee Butthep, Wanida Wongtiraporn, Werasak Sasanakul, Kanchana Tangnararatchakit, Sirichan Chunhakan, Sutee Yoksan Laboratory predictors of dengue shock syndrome during the febrile stage. Southeast Asian Journal of Tropical Medicine and Public Health. Vol.41, No.2 (2010), 326-332. Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/29749
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Title
Laboratory predictors of dengue shock syndrome during the febrile stage
Abstract
The clinical manifestations of dengue hemorrhagic fever (DHF) consist of three successive stages: febrile, toxic and convalescent. The toxic stage is the critical period, which may manifest as circulatory disturbance or even profound shock in some patients. We attempted to determine predictors for the risk of dengue shock syndrome (DSS) during the febrile stage. One hundred one children with acute febrile illness were enrolled in the study, with a mean age of 11 years old. The diagnosis included dengue fever (DF) 21 cases, DHF grade I 30 cases, DHF grade II 33 cases, DHF grades III and IV 10 cases; children with other febrile illnesses (OFI) 7 cases were used as controls. Complete blood counts, coagulation tests, von Willebrand factor antigens (VWF:Ag) and ristocetin cofactor activity (VWF:Rcof) were determined daily during hospitalization and 2-4 weeks after discharge from the hospital. The results revealed any one of the following abnormal laboratory findings during the febrile stage served as a predictor for risk of DSS: increase in hematocrit >25%, a platelet count <40,000/μl, an activated partial thromboplastin time >44 seconds, a prothrombin time >14 seconds, a thrombin time >16 seconds or a VWF:Ag or VWF:Rcof >210%. The relative risk ranged from 4.8 to 10.9. Simple laboratory investigations with complete blood count, coagulation test or the more sophisticated von Willebrand factor, are helpful in predicting the risk for DSS during the febrile stage.