Early predictors to differentiate primary from secondary dengue infection in children

• Main Authors: Aruna Kumari Bandaru, Chandra Sekhar Vanumu
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2016-01-01
• Series: Medical Journal of Dr. D.Y. Patil University
• Subjects: Alanine transaminase; aspartate transaminase; dengue fever; dengue hemorrhagic fever; dengue infection; liver function test
• Online Access: http://www.mjdrdypu.org/article.asp?issn=0975-2870;year=2016;volume=9;issue=5;spage=587;epage=593;aulast=Bandaru

Aim: We aimed to analyze the early predictors to differentiate primary from secondary dengue infection and the severity of liver involvement with reference to mortality. Materials and Methods: This prospective study was conducted on 200 children having acute febrile illness between 3 months to 15 years age group. One hundred and five serologically confirmed dengue patients were included in the study and classified into primary and secondary dengue infection. Liver function tests (LFTs) and electrolytes were analyzed, and the hepatic dysfunction was correlated to the severity of the disease. Results: Of the 105 serologically confirmed dengue, 62 (59%) were primary and 43 (41%) were secondary dengue infection. Primary dengue infection was more common in <1 year age group (35.5%), whereas secondary dengue infection was more common in 6-10 years age group children (41.9%). There was no difference in means of LFTs, but hyponatremia (<134 meq/L) and thrombocytopenia (<50,000/mm3) were more frequent in secondary dengue infection. The mortality rate of dengue infection was 3.8%. Conclusion: Abnormal LFTs can be a marker to predict disease severity, but may not differentiate primary from secondary dengue infection. Occurrence of hyponatremia and thrombocytopenia may identify children likely to have secondary dengue.