Hyperferritinemia in uncomplicated pediatric dengue patients in Kanchipuram, Tamil Nadu, India

  • Dr. S Mohammed Aashiq Post-Graduate, Department of Paediatrics, Meenakshi Medical College Hospital, and Research Centre, Kanchipuram, Tamil Nadu, India
  • Dr. Prahlad Kadambi Post-Graduate, Department of Paediatrics, Meenakshi Medical College Hospital, and Research Centre, Kanchipuram, Tamil Nadu, India
  • Dr. L Sushanth Prabhath Reddy Post-Graduate, Department of Paediatrics, Meenakshi Medical College Hospital, and Research Centre, Kanchipuram, Tamil Nadu, India
  • Dr. S Chithra Assistant Professor, Department of Paediatrics, Meenakshi Medical College Hospital, and Research Centre, Kanchipuram, Tamil Nadu, India
Keywords: Dengue fever, Hematological profile, Hyperferritinemia

Abstract

Background: Dengue fever is an arboviral fever caused by 5 serotypes of Dengue Virus DENV1-5. Ferritin is an acute-phase reactant and produced by reticuloendothelial cells in response to inflammation and infection. Studies have shown that ferritin is a predictor of the severity of dengue. However, there are no studies correlating serum ferritin levels with the Dengue Antibody profile in pediatric patients in India.

Aim: The objectives of this study were to assess serum ferritin levels in pediatric dengue patients, correlate it with the patient’s dengue antibody profile (Dengue IgM and IgG) and to correlate it with the hematological profile in pediatric dengue patients.

Methodology: 58 Children who were admitted for fever of more than 3 days duration and Dengue NS1 antigen positive were included in the study. In these children; Total Count (TLC), Platelet Count (Plt), Hematocrit (PCV), Serum Ferritin levels were the investigative parameters measured at the time of admission for the purpose of the study. These patients were treated as per the WHO Dengue Guidelines. Data were coded and entered in Microsoft Excel 2013 and data was analyzed using SPSS v16. the p-value of <0.05 was considered to be statistically significant.

Results: The mean age of the study population was 8.51±3.5 years. All 58 children had elevated serum ferritin levels. The mean serum ferritin levels in the study population as a whole were 8762.224±3556.09 µg/ml. The mean serum ferritin levels in children who were Dengue IgM negative was 7031.78±2669.44 µg/ml. There was a strong positive association between Serum Ferritin levels and Dengue IgM Status (r= 0.53, p=0.000029).

Conclusions: Hyperferritinemia is seen in dengue fever and is associated with the Dengue IgM status of the child. There is a potential for serum ferritin levels to be used as a marker for diagnosis of dengue fever and in the prediction of the severity of dengue fever but needs to be confirmed in larger studies.

Downloads

Download data is not yet available.

References

Mustafa MS, Rasotgi V, Jain S, Gupta V. Discovery of fifth serotype of dengue virus (DENV-5): A new public health dilemma in dengue control. Med J Armed Forces India. 2015;71(1):67-70. doi: https://doi.org/10.1016/j.mjafi.2014.09.011.

Back AT, Lundkvist A. Dengue viruses-an overview. Infect Ecol Epidemiol. 2013;3(1):10-3 doi: https://doi.org/10.3402/iee.v3i0.19839.

Medhi M, Saikia L, Patgiri SJ, Lakhar V, Hussain ME, Kakati S. Incidence of Japanese Encephalitis amongst acute encephalitis syndrome cases in upper Assam districts from 2012 to 2014 : A report from a tertiary care hospital. Indian J Med Res. 2017;146(2):267-271. doi: https://doi.org/10.4103/ijmr.IJMR_1303_15.

Dayaraj C. Current status of dengue and chikungunya in India. WHO South-East Asia J Public Health. 2014;3(1):22-27. doi: https://doi.org/10.4103/2224-3151.206879.

John JK, Kattoor JJ, Nair AR, Bharathan AP, Valsala R, Sadanandan GV. Kyasanur Forest Disease: an Status Update. Adv Anim Vet Sci. 2014;2(6):329-336. doi: https://doi.org/10.14737/journal.aavs/2014/2.6.329.336.

Gupta N, Srivastava S, Jain A, Chaturvedi UC. Dengue in India. Indian J Med Res. 2012;136(3):373-390. Available from: http://www.ijmr.org.in/text.asp?2012/136/3/373/101976.

Martina BEE, Koraka P, Osterhaus AD. Dengue virus pathogenesis: an integrated view. Clin Microbiol Rev. 2009;22(4):564-581 doi: https://doi.org/10.1128/CMR.00035-09.

Zhang H, Zhou YP, Peng HJ, Zhang XH, Zhou FY, Liu ZH, et al. Predictive symptoms and signs of severe dengue disease for patients with dengue fever: a meta-analysis. Biomed Res Int. 2014;359308. doi: https://doi.org/10.1155/2014/359308.

Singhi, SC. Severe Dengue: Developing a Universally Applicable Simple Prediction Model. Indian J Pediatr. 2018;85:413-414. doi: https://doi.org/10.1007/s12098-018-2668-2.

Guenter W. Modification of iron regulation by the inflammatory response. Best practice & research. Clin Haematol. 2005;18(2):183-201. doi: https://doi.org/10.1016/j.beha.2004.09.001.

van de Weg CA, Huits RM, Pannuti CS, Brouns RM, van den Berg RW, van den Ham HJ, et al. Hyperferritinaemia in dengue virus infected patients is associated with immune activation and coagulation disturbances. PLoS Negl Trop Dis. 2014;8(10):e3214. doi: https://doi.org/10.1371/journal.pntd.0003214.

Soundravally R, Agieshkumar B, Daisy M, Sherin J, Cleetus CC. Ferritin levels predict severe dengue. Infection. 2015;43(1):13-19. doi: https://doi.org/10.1007/s15010-014-0683-4.

World Health Organization. (‎2009)‎. Dengue guidelines for diagnosis, treatment, prevention and control. Available at https://www.who.int/tdr/publications/documents/dengue-diagnosis.pdf.

Garg A, Garg J, Singh DV, Dhole TN. Can rapid dengue diagnostic kits be trusted? A comparative study of commercially available rapid kits for serodiagnosis of dengue fever. J Lab Physicians. 2019;11(1):63-67. doi: https://doi.org/10.4103/JLP.JLP_140_18.

Yam-Puc JC, Cedillo-Barrón L, Aguilar-Medina EM, Ramos-Payán R, Escobar-Gutiérrez A, Flores-Romo L. The Cellular Bases of Antibody Responses during Dengue Virus Infection. Front Immunol. 2016;7:218. doi: https://doi.org/10.3389/fimmu.2016.00218.

CITATION
DOI: 10.17511/ijpr.2020.i03.05
Published: 2020-03-31
How to Cite
Aashiq, S. M., Kadambi, P., Reddy, L. S. P., & S, C. (2020). Hyperferritinemia in uncomplicated pediatric dengue patients in Kanchipuram, Tamil Nadu, India. Pediatric Review: International Journal of Pediatric Research, 7(3), 142-145. https://doi.org/10.17511/ijpr.2020.i03.05
Section
Original Article