EFFECT OF FERRITIN LEVELS ON THE OUTCOME OF DENGUE INFECTION IN CHILDREN
Creators: name: Dr. Vidhyasagar Krishnamoorthy
name: Dr. Thulasi
name: Dr. Vaanmathi Azhagar Nambi Santhi
name: Dr. Muthu Chidambaram Md Dm
name: Balamma Sujatha
name: Dr. Melachuru Sai Padma Charan
Publisher: name: Zenodo
Year: 2024
Subjects: Dengue Infection, Hyperferritinemia, Ferritin Levels.

description: Abstract

Background Appropriate supportive care and early diagnosis can lower the mortality risk in patients with severe dengue illness. To correctly identify patients most likely to benefit from suitable early therapies, it is essential to identify risk factors linked to severe types of dengue illness. A common feature of many disorders is hyperferritinemia, which is defined by a high degree of immunological activation, which includes hemophagocytic lymphohistiocytosis and macrophage activation syndrome, which in turn causes cytokine storms. Ferritin has been demonstrated in earlier research to be a useful marker in the distinction between dengue and other feverish illnesses. Therefore, the goal of the current investigation was to determine whether serum ferritin levels and dengue infection severity are correlated. Methods This descriptive cross-sectional study was conducted between October 2021 to September 2023, spanning two years, among children aged one to sixteen who were admitted to the paediatrics department of Saveetha Medical College and Hospital, Thandalam, exhibiting symptoms of fever, abdominal pain, vomiting, and/or decreased urine output. Clinical signs and symptoms, including positive NS1antigen if they appear within 5 days of illness or IgM/IgG if they appear beyond 5 days, were used to diagnosis dengue infection. Measurements of serum ferritin were made on the first day of admission. Since every kid has a different day of sickness and admission, the serum ferritin level on the first day of admission was used as a proxy for the outcome. If a child's ferritin level was > 500 according to the HLH criteria, they were diagnosed with hyperferritinemia. Results There were 65 children in the study. There were 33 boys and 32 girls in the study group, which was a comparable distribution of males and females. 8.9 years was the average age. Of the study population, 53.8% tested positive for the NS1 antigen, 84.6% tested positive for dengue IgM, and 26.1% tested positive for dengue IgG. Of the participants in the research, 53.8% had hyperferritinemia. A statistically significant correlation was found between hyperferritinemia and positive dengue IgM test results. The amount of NS 1 antigen and dengue IgG did not show any statistical significance. Children that are stunted or underweight have elevated ferritin levels. A PICU admission was required for every child with elevated ferritin levels, a statistically significant finding. Hyperferritinemia subjects were statistically significantly (p = 0.000) more likely to experience shock, PICU hospitalisation, and inpatient days. The total WBC count (3872.4 ± 1481.11) and platelet count (0.605 ±.313) were significantly lower in children with hyperferritinemia. A statistically significant rise was observed in the levels of SGOT (181.77 ± 151.99) and SGPT (74.57 ± 74.79) in children diagnosed with hyperferritinemia. Conclusıon One potential clinical sign of DENV infection is hyperferritinaemia. Ferritin may also be used as a marker for dengue infection severity in terms of hospital stay, shock, and fluid spacing. Elevated liver enzymes indicate more liver damage in children with hyperferritinemia.