AJTMH ASTMH Job Mart
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Am. J. Trop. Med. Hyg., 65(6), 2001, pp. 840-847
Copyright © 2001 by The American Society of Tropical Medicine and Hygiene

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Krishnamurti, C
Right arrow Articles by Innis, B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Krishnamurti, C
Right arrow Articles by Innis, B.
Related Collections
Right arrow Travel Medicine
Right arrow Dengue
American Journal of Tropical Medicine and Hygiene, Vol 65, Issue 6, 840-847
Copyright © 2001 by American Society of Tropical Medicine and Hygiene

Research Articles


Mechanisms of hemorrhage in dengue without circulatory collapse

C Krishnamurti, S Kalayanarooj, MA Cutting, RA Peat, SW Rothwell, TJ Reid, S Green, A Nisalak, TP Endy, DW Vaughn, S Nimmannitya, and BL Innis

To characterize the molecular basis for the hemostatic defects of dengue infections, a study was conducted in Bangkok, Thailand. Febrile children (n = 68) hospitalized with suspected dengue were enrolled before their clinical syndromes were classified as either dengue fever (DF) or dengue hemorrhagic fever (DHF). Hospital course and outcome were recorded; blood was obtained during the febrile illness (S1), after defervescence (S2), and 1 month after onset of disease (S4). Patients were classified as DF (n = 21) and DHF grades 1, 2, and 3; (DHF1, n = 8; DHF2, n = 30; and DHF3, n = 9). All had marked thrombocytopenia. Bleeding scores were assigned on the basis of bleeding site. Although there was no correlation between bleeding scores and pleural effusion index (a measure of vascular leakage) or bleeding scores and platelet counts, there was a correlation between pleural effusion index and platelet counts. Bleeding scores did not correlate with hemostatic data. Activated partial thromboplastin time was prolonged, with trends toward decreased fibrinogen and increased levels of prothrombin fragment F1.2 in the acute-phase samples. However, no factor level was dramatically decreased. We conclude that most patients with DF or DHF, even without overt hemorrhage, have consumptive coagulopathy. Nevertheless, hemorrhage in dengue without circulatory collapse is most likely due to activation of platelets rather than coagulopathy, which is well compensated. Our data suggest that vascular alteration may be the principal factor involved in the association of thrombocytopenia and hemorrhage with disease severity.


This article has been cited by other articles:


Home page
 Am J Trop Med HygHome page
L. Thomas, O. Verlaeten, A. Cabie, S. Kaidomar, V. Moravie, J. Martial, F. Najioullah, Y. Plumelle, C. Fonteau, P. Dussart, et al.
Influence of the Dengue Serotype, Previous Dengue Infection, and Plasma Viral Load on Clinical Presentation and Outcome During a Dengue-2 and Dengue-4 Co-Epidemic
Am J Trop Med Hyg, June 1, 2008; 78(6): 990 - 998.
[Abstract] [Full Text] [PDF]

Home page
 QJMHome page
G.N. Malavige, V.G.N.S. Velathanthiri, E.S. Wijewickrama, S. Fernando, S.D. Jayaratne, J. Aaskov, and S.L. Seneviratne
Patterns of disease among adults hospitalized with dengue infections
QJM, May 1, 2006; 99(5): 299 - 305.
[Abstract] [Full Text] [PDF]

Home page
 Am J Trop Med HygHome page
S. N. HAMMOND, A. BALMASEDA, L. PEREZ, Y. TELLEZ, S. I. SABORIO, J. C. MERCADO, E. VIDEA, Y. RODRIGUEZ, M. A. PEREZ, R. CUADRA, et al.
DIFFERENCES IN DENGUE SEVERITY IN INFANTS, CHILDREN, AND ADULTS IN A 3-YEAR HOSPITAL-BASED STUDY IN NICARAGUA
Am J Trop Med Hyg, December 1, 2005; 73(6): 1063 - 1070.
[Abstract] [Full Text] [PDF]

Home page
 Am J Trop Med HygHome page
C. C. CARLOS, K. OISHI, M. T. D. D. CINCO, C. A. MAPUA, S. INOUE, D. J. M. CRUZ, M. A. M. PANCHO, C. Z. TANIG, R. R. MATIAS, K. MORITA, et al.
COMPARISON OF CLINICAL FEATURES AND HEMATOLOGIC ABNORMALITIES BETWEEN DENGUE FEVER AND DENGUE HEMORRHAGIC FEVER AMONG CHILDREN IN THE PHILIPPINES
Am J Trop Med Hyg, August 1, 2005; 73(2): 435 - 440.
[Abstract] [Full Text] [PDF]

Home page
 J. Gen. Virol.Home page
D. Talavera, A. M. Castillo, M. C. Dominguez, A. E. Gutierrez, and I. Meza
IL8 release, tight junction and cytoskeleton dynamic reorganization conducive to permeability increase are induced by dengue virus infection of microvascular endothelial monolayers
J. Gen. Virol., July 1, 2004; 85(7): 1801 - 1813.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2001 by the American Society of Tropical Medicine and Hygiene.