Serum ferritin levels in children with dengue infection.
The purpose of this study was to evaluate the levels of ferritin, an acute-phase reactant, in predicting the risk of dengue hemorrhagic fever (DHF) in patients with dengue infection. One hundred seventy-seven Thai children (100 males, 77 females) 4-16 years old (median age 11 years) with DF (n = 44) and DHF (n = 133) were enrolled in the study. All patients had serologic confirmation of dengue infection. Each had a venous blood sample drawn daily during hospitalization and at the outpatient clinic 2-4 weeks after discharge from the hospital, to determine serum ferritin levels. The median serum ferritin levels (ng/ml) in children with DHF (Day 2, 974; Day 3, 624; Day 4, 1,136; Day 5, 1,912; Day 6, 2, 105; Day 7, 1,840; Day 8, 1,478 and Day 9, 1,144 of illness) were higher than those with DF (Day 2, 25.4; Day 3, 45.6; Day 4, 655; Day 5, 1,050; Day 6, 1,075; Day 7, 615; Day 8, 764 and Day 9, 600 of illness) with p-values of 0.013, 0.001 and 0.013 on Days 5, 6 and 7 of illness, respectively. A cutoff level of serum ferritin of 1,200 ng/ml was used to calculate sensitivity and specificity for DHF. The results reveal the sensitivities on Days 5, 6 and 7 of illness were 81.5, 84.4 and 89.9%, respectively, and the specificities were 42.4, 39.0 and 36.4%, respectively. High serum ferritin levels > or = 1,200 ng/ml may be a predictor of dengue hemorrhagic fever.
Chaiyaratana
Wathanee
W
Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. rawcy@mahidol.ac.th
Chuansumrit
Ampaiwan
A
Atamasirikul
Kalayanee
K
Tangnararatchakit
Kanchana
K
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003715:Dengue / Q000097:blood*; D005260:Female; D005293:Ferritins / Q000097:blood*; D006801:Humans; D008297:Male; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D019595:Severe Dengue / Q000097:blood
D015415:Biomarkers; D005293:Ferritins