title: Role of cognitive parameters in dengue hemorrhagic fever and dengue shock syndrome.
abstract: Dengue is becoming recognized as one of the most important vector-borne human diseases. It is predominant in tropical and subtropical zones but its geographical distribution is progressively expanding, making it an escalating global health problem of today. Dengue presents with spectrum of clinical manifestations, ranging from asymptomatic, undifferentiated mild fever, dengue fever (DF), to dengue hemorrhagic fever (DHF) with or without shock (DSS), a life-threatening illness characterized by plasma leakage due to increased vascular permeability. Currently, there are no antiviral modalities or vaccines available to treat and prevent dengue. Supportive care with close monitoring is the standard clinical practice. The mechanisms leading to DHF/DSS remains poorly understood. Multiple factors have been attributed to the pathological mechanism, but only a couple of these hypotheses are popular in scientific circles. The current discussion focuses on underappreciated factors, temperature, natural IgM, and endotoxin, which may be critical components playing roles in dengue pathogenesis.
authors.affiliation: Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. jjjits@cc.kmu.edu.tw.
authors.forename: Jih-Jin
authors.initials: JJ
authors.lastname: Tsai
authors.forename: Kulkanya
authors.initials: K
authors.lastname: Chokephaibulkit
authors.forename: Po-Chih
authors.initials: PC
authors.lastname: Chen
authors.forename: Li-Teh
authors.initials: LT
authors.lastname: Liu
authors.forename: Hui-Mien
authors.initials: HM
authors.lastname: Hsiao
authors.forename: Yu-Chih
authors.initials: YC
authors.lastname: Lo
authors.forename: Guey Chuen
authors.initials: GC
authors.lastname: Perng
mesh_terms: D018407:Bacterial Physiological Phenomena; D003716:Dengue Virus / Q000502:physiology*; D004731:Endotoxins / Q000009:adverse effects / Q000097:blood; D006801:Humans; D007075:Immunoglobulin M / Q000009:adverse effects / Q000097:blood; D019595:Severe Dengue / Q000503:physiopathology* / Q000821:virology*; D013696:Temperature
chemical_list: D004731:Endotoxins; D007075:Immunoglobulin M