Features of DIC in Dengue Hemorrhagic Fever

Funahara, Y; Sumarmo,; Wirawan, Riadi

doi:10.1159/000408460

Cited by 18 publications

(17 citation statements)

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“…Previous studies of patients with severe DHF have found prolonged PT and aPTT with a concomitant decrease in factor VII. 17,18 Some studies also found a mild to moderate decrease in factors V, VII, VIII, IX, and X, 17,19 but all patients in those studies had severe DHF. Moreover, transient liver injury indicated by elevated AST may explain TT prolongation: liver injury may cause dysfunctional fibrinogen.…”

Section: Discussionmentioning

confidence: 97%

Mechanisms of hemorrhage in dengue without circulatory collapse.

Krishnamurti¹,

Kalayanarooj²,

Cutting³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

114

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Section: Discussionmentioning

confidence: 97%

Mechanisms of hemorrhage in dengue without circulatory collapse.

Krishnamurti¹,

Kalayanarooj²,

Cutting³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

114

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“…Our study demonstrated that patients in the first days of DVI already met at least two out of four criteria for DIC (low platelets and high PDF). Studies addressing hemostasis in DHF patients showed that all DHF patients manifested acute type of DIC [19, 20, 25]. Prolongation of aPTT and PT, decreased platelets count, plasma fibrinogen level, prothrombin, factor VIII, plasminogen and antithrombin III activities were observed transiently during acute phase of DHF [9, 20, 25] and they characterize hemorrhagic diathesis of DVI severe patients [3, 4, 20, 21, 25].…”

Section: Discussionmentioning

confidence: 99%

Thromboelastometry analysis of thrombocytopenic dengue patients: a cross-sectional study

et al. 2017

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BackgroundDengue virus infection (DVI) is a prevalent and potentially fatal viral disease associated with coagulopathy. So far, the coagulation profile of DVI patients with thrombocytopenia has not been assessed through a viscoelastic test such as rotational thromboelastometry. We aimed to describe the prevalence and characteristics of coagulation abnormalities in dengue fever outpatients with thrombocytopenia, addressed by both rotational thromboelastometry and conventional coagulation tests.MethodsThis was a cross-sectional study conducted between April 6th and May 5th 2015 in São Paulo, Brazil during a dengue outbreak. Thromboelastometry (ROTEM®) and the conventional coagulation tests prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), thrombin time (TT), platelet count and fibrinogen levels were performed in 53 patients with DVI and thrombocytopenia.ResultsDespite a median interquartile range (IQR) platelet count of 77 (63–88) x 109/L in DVI patients, conventional coagulation tests and plasma fibrinogen levels were within the normal range. Subjects demonstrated hypocoagulability in 71.7% (38/53) in INTEM and 54.7% (29/53) in EXTEM DVI patients. FIBTEM analyses detected only 5.7% (3/53) with hypocoagulability among this population. The median (IQR) clotting time (CT), clot formation time (CFT) and maximum clot firmness (MCF) on INTEM were, respectively, 177 (160–207) sec, 144 (108–178) sec and 48 (42–52) mm. On EXTEM, median (IQR) CT, CFT and MCF were, respectively, 69 (65–78) sec, 148 (126–198) sec and 49 (44–55) mm. Median (IQR) MCF on FIBTEM was 15 (13–18) mm.ConclusionThromboelastometry impairment is highly prevalent in DVI patients with thrombocytopenia, particularly in INTEM and EXTEM analyses, while standard coagulation tests are normal in this setting. Clinical implications remain to be established.

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“…10 Thrombocytopenia is a marker of clinical severity as per WHO guidelines. 11,12 It was found that markedly elevated transaminases (>200U/L) showed a significant association with mortality. The p value calculated was 0.070 and <0.001 for ALT and AST respectively.…”

Section: -35mentioning

confidence: 99%

Predictors of mortality in adult patients with dengue: a study from South India

et al. 2018

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Background: Dengue is one of the important causes of acute febrile illnesses in India. Dengue can be a fatal disease, however there are no reliable markers which can predict mortality among these patients.Methods: A prospective cross sectional study was done in patients who were admitted to a tertiary care hospital with features of dengue fever. A total of 364 patients with IgM dengue serology positive were included in the study. Relevant clinical and laboratory parameters were collected from all patients. Association between clinico-laboratory parameters with mortality was studied using appropriate statistical methods.Results: Among the 364 patients recruited in this study, 14 (3.85%) patients died. Mortality among patients with age group 18-40 years was 2.04%, in patients aged above 40 years was 7.56%. Mortality among patients with hypotension was 42.42% (14 out of 33), bleeding manifestations was 15.38% (8/52), platelets <20,000/mm3 was 10.41% (10/96), ALT >200 was 13.04% (6/46), AST>200 was 12.34% (10/81), prolonged prothrombin time was 60%(12/20), renal failure was 28%(14/50), encephalopathy was 31.57% (6/19), multi organ dysfunction syndrome(MODS) was 43.33% (13/30), acute respiratory distress syndrome (ARDS) was 45.45% (5/11), pleural effusion was 7.5% (6/80).Conclusions: The overall mortality in the present study was 3.85%. Following variables were associated with increased risk of death among the dengue patients: Age >40 years, presence of hypotension, platelets <20000 cells/mm3, ALT>200U/L, AST>200U/L, prolonged prothrombin time, presence of renal failure, encephalopathy, MODS, ARDS and bleeding tendency (p value <0.05). Early identification of factors associated with mortality can help to make appropriate decision on care required.

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Features of DIC in Dengue Hemorrhagic Fever

Cited by 18 publications

References 0 publications

Mechanisms of hemorrhage in dengue without circulatory collapse.

Mechanisms of hemorrhage in dengue without circulatory collapse.

Thromboelastometry analysis of thrombocytopenic dengue patients: a cross-sectional study

Predictors of mortality in adult patients with dengue: a study from South India

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