CLINICAL CHARACTERISTICS AND LABORATORY PARAMETERS IN DENGUE HEMORRHAGIC FEVER

Main Article Content

Talha Tariq
Aizaz Ali Khan
Noor Ul Amin
Emaan Saeed
Alisha Saleem
Amna Khalid
Syeda Wajiha Rehan
Hafiza Sidra

Keywords

CBC, Dengue, Antioxidants, Patients

Abstract

Introduction: Dengue is an infection caused by Dengue virus which transmitted by the bite of an infected mosquito.


Objectives: The main objective of the study is to find the clinical characteristics and laboratory parameters in Dengue hemorrhagic fever among local population of Pakistan.


Material and methods: This cross sectional study was conducted in RYK Teaching Hospital Rahim Yar Khan Pakistan. The data was collected from 200 patients of both genders. Clinical data was collected from medical records and compared between the dengue and control groups included demographic data, clinical presentations and all parameters from the CBC.


Results: The results indicate a significant reduction in T-SOD activity in the serum of infected patients (220.15 ± 34.50 U/ml.mg) compared to controls (310.45 ± 39.20 U/ml.mg) (p<0.05), suggesting increased oxidative stress during dengue infection. Additionally, MDA levels, a marker of lipid peroxidation, were significantly elevated in infected patients (6.12 ± 1.35 nmol/ml.mg) compared to controls (3.98 ± 0.40 nmol/ml.mg) (p<0.05), further highlighting oxidative damage. Conclusion: It is concluded that dengue infection significantly alters oxidative stress markers and hematological parameters, leading to reduced SOD and CAT activity, elevated MDA levels, and a decreased GSSG/GSH ratio in both serum and liver. These changes reflect the oxidative damage and systemic stress associated with the disease, emphasizing the need for early intervention to mitigate these effects.


 

Abstract 84 | PDF Downloads 59

References

1. Palamara AT, Perno CF, Ciriolo MR, Dini L, Balestra E, et al. (1995) Evidence for antiviral activity of glutathione: in vitro inhibition of herpes simplex virus type 1 replication. Antiviral Res 27: 237–253.
2. Ciriolo MR, Palamara AT, Incerpi S, Lafavia E, Bue MC, et al. (1997) Loss of GSH, oxidative stress, and decrease of intracellular pH as sequential steps in viral infection. J Biol Chem 272: 2700–2708.
3. Droge W, Schulze-Osthoff K, Mihm S, Galter D, Schenk H, et al. (1994) Functions of glutathione and glutathione disulfide in immunology and immunopathology. FASEB J 8: 1131–1138.
4. Nencioni L, Iuvara A, Aquilano K, Ciriolo MR, Cozzolino F, et al. (2003) Influenza A virus replication is dependent on an antioxidant pathway that involves GSH and Bcl-2. FASEB J 17: 758–760.
5. Garaci E, Palamara AT, Ciriolo MR, D’Agostini C, Abdel-Latif MS, et al. (1997) Intracellular GSH content and HIV replication in human macrophages. J Leukoc Biol 62: 54–59.
6. Kalebic T, Kinter A, Poli G, Anderson ME, Meister A, et al. (1991) Suppression of human immunodeficiency virus expression in chronically infected monocytic cells by glutathione, glutathione ester, and N-acetylcysteine. Proc Natl Acad Sci U S A 88: 986–990.
7. Matthias LJ, Yam PT, Jiang XM, Vandegraaff N, Li P, et al. (2002) Disulfide exchange in domain 2 of CD4 is required for entry of HIV-1. Nat Immunol 3: 727–732.
8. Cai J, Chen Y, Seth S, Furukawa S, Compans RW, et al. (2003) Inhibition of influenza infection by glutathione. Free Radic Biol Med 34: 928–936.
9. Palamara AT, Garaci E, Rotilio G, Ciriolo MR, Casabianca A, et al. (1996) Inhibition of murine AIDS by reduced glutathione. AIDS Res Hum Retroviruses 12: 1373–1381.
10. Fraternale A, Paoletti MF, Casabianca A, Nencioni L, Garaci E, et al. (2009) GSH and analogs in antiviral therapy. Mol Aspects Med 30: 99–110.
11. Chaloemwong, J., Tantiworawit, A., Rattanathammethee, T. et al. Useful clinical features and hematological parameters for the diagnosis of dengue infection in patients with acute febrile illness: a retrospective study. BMC Hematol 18, 20 (2018). https://doi.org/10.1186/s12878-018-0116-1
12. Ho, TS., Wang, SM., Lin, YS. et al. Clinical and laboratory predictive markers for acute dengue infection. J Biomed Sci 20, 75 (2013). https://doi.org/10.1186/1423-0127-20-75
13. David A. Muller, Alexandra C. I. Depelsenaire, Paul R. Young, Clinical and Laboratory Diagnosis of Dengue Virus Infection, The Journal of Infectious Diseases, Volume 215, Issue suppl_2, 1 March 2017, Pages S89–S95, https://doi.org/10.1093/infdis/jiw649
14. Kabra SK, Jain Y, Singhal T, Ratageri VH. Dengue hemorrhagic fever: clinical manifestations and management. Indian J Pediatr. 1999 Jan-Feb;66(1):93-101. doi: 10.1007/BF02752362. PMID: 10798041.
15. Mallhi TH, Khan AH, Adnan AS, Sarriff A, Khan YH, Jummaat F. Clinico-laboratory spectrum of dengue viral infection and risk factors associated with dengue hemorrhagic fever: a retrospective study. BMC Infect Dis. 2015 Sep 30;15:399. doi: 10.1186/s12879-015-1141-3. PMID: 26423145; PMCID: PMC4590689.
16. Lee MS, Hwang KP, Chen TC, Lu PL, Chen TP. Clinical characteristics of dengue and dengue hemorrhagic fever in a medical center of southern Taiwan during the 2002 epidemic. J Microbiol Immunol Infect. 2006 Apr;39(2):121-9. PMID: 16604244.