Dengue hemorrhagic fever in infants: a study of clinical and cytokine profiles.
A prospective study of clinical and cytokine profiles of 107 infants with dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS) was conducted. Fever, petechiae on the skin, and hepatomegaly were the most common clinical findings associated with DHF/DSS in infants. DSS occurred in 20.5% of the patients. Hemoconcentration and thrombocytopenia were observed in 91.5% and 92.5% of the patients, respectively. Serologic testing revealed that almost all of the patients (95.3%) had primary dengue virus infections. These data demonstrate that clinical and laboratory findings of DHF/DSS in infants are compatible with the World Health Organization's clinical diagnostic criteria for pediatric DHF. The present study is the first to report evidence of production of cytokines in infants with DHF/DSS and to describe the difference between the cytokine profile of infants with primary dengue virus infections and children with secondary infections. Overproduction of both proinflammatory cytokines (interferon-gamma and tumor necrosis factor-alpha) and anti-inflammatory cytokines (interleukin-10 and -6) may play a role in the pathogenesis of DHF/DSS in infants.
Nguyen
Thanh Hung
TH
Department of Dengue Hemorrhagic Fever, Children's Hospital No. 1-Ho Chi Minh City, Vietnam. hungdhf@hcm.fpt.vn
Lei
Huan-Yao
HY
Nguyen
Trong Lan
TL
Lin
Yee-Shin
YS
Huang
Kao-Jean
KJ
Le
Bich Lien
BL
Lin
Chiou-Feng
CF
Yeh
Trai-Ming
TM
Do
Quang Ha
QH
Vu
Thi Que Huong
TQ
Chen
Lien-Cheng
LC
Huang
Jyh-Hsiung
JH
Lam
Thi My
TM
Liu
Ching-Chuan
CC
Halstead
Scott B
SB
D000914:Antibodies, Viral / Q000097:blood; D001777:Blood Coagulation; D016207:Cytokines / Q000097:blood*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007371:Interferon-gamma; D016753:Interleukin-10 / Q000097:blood; D008099:Liver / Q000503:physiopathology; D011486:Protein C / Q000032:analysis; D017293:Protein S / Q000032:analysis; D019595:Severe Dengue / Q000097:blood / Q000276:immunology* / Q000503:physiopathology; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D000914:Antibodies, Viral; D016207:Cytokines; D011486:Protein C; D017293:Protein S; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D007371:Interferon-gamma