Abstract
Objective: The aim of the study is to identify whether Atypical Lymphocyte (AL), liver transaminases, and Glutathione Reductase (GR) can be used as potential biomarkers in the assessment of severity and thrombocytopenia in dengue. Methods: A cross-sectional analytical study was carried out on diagnosed dengue patients admitted to Nawaloka Hospital, Sri Lanka. Blood samples were taken from patients (n = 50) on the day of admission, 3rd and 5th day from admission for analysis of GR, aspartate transaminase, alanine transaminase, platelets, white blood cells, and Atypical Lymphocytes (AL). Results: GR level of all three measured stages had a higher area under the curve (>88%), high sensitivity and specificity compared to liver transaminases. A significant regression model represents on admission GR and AL levels as predictive variables to platelet levels in day 03 from admission (Day 3 Platelet level = 127155.3 - 383 * GR - 0.431 * AL). Conclusion: Liver transaminases, GR, and AL% can be considered as a profile of predictive biomarkers in early diagnosis of severity of dengue infection. The degree of thrombocytopenia can be predicted using on admission GR and AL% level in acute dengue viral infection.
Highlights
Dengue is a mosquito-borne viral disease, extent in many tropical and subtropical regions in the world
This study was carried out to determine the predictive power of Glutathione Reductase (GR), liver transaminases, and Atypical Lymphocytes (AL)% on prediction severity and thrombocytopenia level in dengue viral infection
A previous study has observed a higher level of AL count among dengue/dengue hemorrhagic fever patients compared to patients with dengue like syndrome [11]
Summary
Dengue is a mosquito-borne viral disease, extent in many tropical and subtropical regions in the world. All of above-mentioned laboratory methods and clinical classifications are only to diagnose dengue fever and not predicting the severity of the disease. Assessment of liver transaminases was identified as a predictive indicator of the severity of dengue fever [7]. A consistent high serum chymase level reported as a predictive marker of dengue hemorrhagic fever [8]. Experimental fact of immune pathology is a fundamental requirement in elucidating of severe dengue fever [9]. The dengue associated liver injury can be both viral induced or immune mediated. Present study assessed the longitudinal changes (on admission, 3rd day from admission and 5th day from admission) of AL, GR, AST and ALT as predictive indicators of severity and thrombocytopenia in dengue viral infection. The present study has been identified whether these biomarkers can be used as potential biomarkers in the assessment of severity and thrombocytopenia in dengue viral infection
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