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Am. J. Trop. Med. Hyg., 78(3), 2008, pp. 370-374
Copyright © 2008 by The American Society of Tropical Medicine and Hygiene

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Biochemical Alterations as Markers of Dengue Hemorrhagic Fever

Luis Angel Villar-Centeno*, Fredi Alexander Díaz-Quijano, AND Ruth Aralí Martínez-Vega
School of Medicine, and Centro de Investigaciones Epidemiológicas, Universidad Industrial de Santander, Bucaramanga, Colombia

We evaluated biochemical alterations as predictors of dengue hemorrhagic fever (DHF). Patients with confirmed infection with dengue virus were prospectively evaluated for the first seven days of disease to determine their final clinical outcome. Serum samples taken 48–96 hours after onset of fever were used for biochemical tests. Of 199 patients, 30 developed DHF. Cases of DHF had higher levels of lactate dehydrogenase (LDH), creatine kinase (CK), and aspartate aminotransferase, and lower levels of albumin, total cholesterol, and triglycerides. Multivariate analysis showed that early alterations of CK (hazard ratio [HR] = 6.98, 95% confidence interval [CI] = 2.34–20.85, P = 0.001), LDH (HR = 3.19, 95% CI = 1.01–10.12, P < 0.05), and albumin (HR = 2.54, 95% CI = 1.09–5.92, P = 0.03) were associated with DHF. Triglyceride levels > 160 mg/dL were negatively associated with developing DHF (HR = 0.07, 95% CI = 0.01–0.59, P = 0.01). Early alterations of biochemical markers can predict DHF in patients with acute fever caused by dengue.

Received December 12, 2006. Accepted for publication December 19, 2007.

Acknowledgments: We thank Raquel Elvira Ocazionez, Sergio Gómez, and Fabián Cortés (Centro de Investigación en Enfermedades Tropicales) and Karol Patricia Torres (Laboratorio Clnico í de la Facultad de Salud de la Universidad Industrial de Santander) for help with laboratory diagnosis and biochemical tests.

Financial support: This study was supported by the Instituto Colombiano para el Desarrollo de la Ciencia y la Tecnología Francisco José de Caldas and the Universidad Industrial de Santander research contract 1102-04-12919.

* Address correspondence to Luis Angel Villar-Centeno, Centro de Investigaciones Epidemiológicas, Facultad de Salud, Universidad Industrial de Santander, Carrera 32 No. 29–31, Bucaramanga, Colombia. E-mail: luisangelvillarc{at}yahoo.com

Authors’ addresses: Luis Angel Villar-Centeno, School of Medicine, Universidad Industrial de Santander, Bucaramanga, Colombia, E-mail: luisangelvillarc{at}yahoo.com. Fredi Alexander Díaz-Quijano and Ruth Aralí Martínez-Vega, Centro de Investigaciones Epidemiológicas, Universidad Industrial de Santander, Bucaramanga, Colombia.






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