Scientific Comments in the literature. Thus further studies on this theme addressing some other parameters related to iron levels other than ferritin should be evaluated to better understand the relationship between GSTs and iron status in sickle cell disease. References 1. Mo Z, Gao Y, Cao Y, Gao F, Jian L. An updating meta-analysis of the GSTM1,GSTT1, and GSTP1 polymorphisms and prostate cancer: a HuGE review. Prostate. 2009;69(6):662-88. 2. Bessa SS, Ali EM, Hamdy SM. The role of glutathione S-transferase M1 and T1 gene polymorphisms and oxidative stress-related parameters in Egyptian patients with essential hypertension. Eur J Intern Med. 2009;20(6):625-30. xxx 3. Fertrin KY, Costa FF. Genomic polymorphisms in sickle cell disease: implications for clinical diversity and treatment. Expert Rev Hematol. 2010;3(4):443-58. 4. Frenett PS, Atweh GF. Sickle cell disease: old discoveries, new concepts, and future promise. J Clin Invest. 2007;117(4):850-8. 5. 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Hematological and biochemical findings in patients with dengue fever: a current issue Rivaldo Venâncio da Cunha1 Éveny Cristine Luna de Oliveira2 1Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul – UFMS, Campo Grande, MS, Brazil 2Hematology and Hemotherapy Service, Hospital Universitário, Universidade Federal de Mato Grosso do Sul – UFMS, Campo Grande, MS, Brazil Conflict-of-interest disclosure: The author declares no competing financial interest Submitted: 2/14/2012 Accepted: 2/15/2012 Corresponding author: Rivaldo Venâncio da Cunha Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul – UFMS Av. Filinto Muller, S/N – Universitário 79074-460 – Campo Grande, MS, Brazil Phone: 55 67 3345-3135 rivaldo_venancio@uol.com.br www.rbhh.org or www.scielo.br/rbhh DOI: 10.5581/1516-8484.20120026 78 Dengue fever epidemics pose a serious issue in public health as they are conditioned to the existence of the so-called social determinants in the health-disease process, which potentiate the emergence of new mosquito breeding sites, limit the results of vector control measures and hamper access to health services. Among the social determinants in Brazil, the accelerated population growth in urban centers, the still considerable intermittence in potable water supplies and the collection and disposal of solid waste are worth mentioning. Although presenting significant improvements over the last decade, these social constraints will unfortunately last for many years, especially in the outskirts of most medium and large cities. Since the reintroduction of dengue fever in 1986, about seven million cases of the disease have been reported in Brazil, thousands of which are considered dengue hemorrhagic fever according to the former classification of the World Health Organization. Since the epidemics recorded from 2007 to 2009, signs of worsening clinical forms have been seen, especially in under 15-year-old patients. The magnitude of the epidemics and the resulting deaths have had a powerful impact on the healthcare network, overcrowding health facilities with suspected cases and, in some instances, triggering real social upheaval. The absence of specific treatment and effective prevention reinforce the relevance of studies involving still unknown aspects of the severe forms of the disease. Thus, the article "Dengue: hematological and biochemical profile dynamics"(1) is an important contribution to the management of the disease. Although not completely understood, the pathophysiology of dengue fever has organic and tissue impacts from the direct action of the virus to immune mechanisms triggered by the infected organism, mainly resulting from the presence of antibodies against viral proteins. Antibodies produced against nonstructural protein 1 (NS1) also react with platelets and endothelial cells and other viral proteins (core, prM, and E) present sequences homologous to diverse coagulation molecules.(2-4) The variable degrees of bleeding seen in dengue fever arise from defects in the first phase of hemostasis as a result of thrombopathy and vascular abnormalities, but also from more serious flaws in blood coagulation, such as disseminated intravascular coagulation. Coagulopathy in dengue hemorrhagic fever has been associated with a reduction in antithrombin III and α-2-anti-plasmin. There are mild or moderate reductions in factors II, V, VII, VIII, IX, X and XII and a slight increase in D-dimer. In necropsies of patients with dengue shock, widespread fibrin thrombi were seen in the lungs, bone marrow, kidneys, adrenal gland and brain.(5) Histopathological studies suggest that dengue-infected patients have some bone marrow suppression characterized by generalized hypoplasia by the fourth day after the Rev Bras Hematol Hemoter. 2012;34(2):73-9