DOI: http://dx.doi.org/10.20473/ijtid.v6i4.3456

PLASMA LEAKAGE PROFILES OF DENGUE HEMORRHAGIC FEVER PATIENTS IN RSUD Dr. SOETOMO, SURABAYA, EAST JAVA, INDONESIA JANUARY – JUNE 2014

Ferdian Rizaliansyah, Aryati Aryati, Musofa Rusli

Abstract


Plasma leakage is one crucial point of dengue hemorrhagic fever (DHF) that differentiates it from dengue fever (DF). DHF has to meet 4 criteria which are 2 – 7 days of acute fever, hemorrhagic manifestation, thrombocytopenia (≤100.000 cells/mm3) and evidence of plasma leakage. Plasma leakage consists of increasing hematocrit ≥20%, hypoalbuminemia or evidence of pleural effusion or ascites. Often doctors only base their DHF diagnosis on the presence of thrombocytopenia. This study analyzed the presence of plasma leakage between adult and pediatric patients with a DHF diagnosis in RSUD Dr. Soetomo in order to make the diagnosis and healthcare services better in the future. This was a retrospective study which used medical records of DHF patients admitted from January to June 2014. 78 cases were included, 24 adult patients (31%) and 54 pediatric patients (69%). 29/78 (37%) patients had no evidence of plasma leakage. No adult patients had ascites whereas 11/54 (20%) pediatric patients presented with ascites. No adult patients had pleural effusion whereas 25/54 (53%) pediatric patients did. Most adult patients that had serum albumin checked had normal albumin levels (12/14 [86%]) while only 14/28 (52%) pediatric patients had normal albumin level. 5/22 (23%) adult patients versus 32/53 (60%) pediatric patients showed hematocrit increments ≥20%. Patients admitted with dengue virus infection may currently be often misclassified as DHF because there are no plasma leakage manifestation in some patients.. There are significant differences in plasma leakage manifestations between adult and pediatric patients which poses a theory that pediatric patients are more susceptible to have plasma leakage manifestations than adult patients.


Keywords


plasma leakage; dengue hemorrhagic fever; dengue fever; pediatric patients; adult patients

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References


WHO, editor. Comprehensive guidelines for prevention and control of dengue and dengue haemorrhagic fever. 1st ed. World Health Organization. New Delhi-India: World Health Organization Regional Office for South-East Asia; 2011.

Indonesia KKR. Profil Kesehatan Indonesia tahun 2014. Jakarta: Kementerian Kesehatan RI; 2015. 1-382 p.

Aryati. Buku Ajar Demam Berdarah Dengue (Tinjauan Laboratoris). Surabaya: Global Persada Press; 2011.

Kalayanarooj S. Dengue classification: current WHO vs. the newly suggested classification for better clinical application? J Med Assoc Thai. 2011 Aug;94 Suppl 3:S74-84.

Suwarto S, Nainggolan L, Sinto R, Effendi B, Ibrahim E, Suryamin M, et al. Dengue score: a proposed diagnostic predictor for pleural effusion and/or ascites in adults with dengue infection. BMC Infect Dis. 2016 Dec 8;16(1):322.

Srikiatkhachorn A, Gibbons R V, Green S, Libraty DH, Thomas SJ, Endy TP, et al. Dengue hemorrhagic fever: the sensitivity and specificity of the world health organization definition for identification of severe cases of dengue in Thailand, 1994-2005. Clin Infect Dis. 2010 Apr 15;50(8):1135–43.

Navarrete-Espinosa J, Gómez-Dantés H, Germán Celis-Quintal J, Vázquez-Martínez JL. Clinical profile of dengue hemorrhagic fever cases in Mexico. Salud Publica Mex. 2005 Jun;47(3).

Balasubramanian S, Janakiraman L, Kumar SS, Muralinath S, Shivbalan S. A reappraisal of the criteria to diagnose plasma leakage in dengue hemorrhagic fever. Indian Pediatr. 2006 Apr;43(4):334–9.

Srikiatkhachorn A, Krautrachue A, Ratanaprakarn W, Wongtapradit L, Nithipanya N, Kalayanarooj S, et al. Natural history of plasma leakage in dengue hemorrhagic fever: a serial ultrasonographic study. Pediatr Infect Dis J. 2007 Apr;26(4):283-90-2.

World Health Organization. Dengue: guidelines for diagnosis, treatment, prevention, and control. Spec Program Res Train Trop Dis. 2009;x, 147.

Hooper C, Lee YCG, Maskell N. Investigation of a unilateral pleural effusion in adults: British Thoracic Society pleural disease guideline 2010. Thorax. 2010 Aug 1;65(Suppl 2):ii4-ii17.

Craig Blackmore C, Black WC, Dallas R V., Crow HC. Pleural fluid volume estimation: A chest radiograph prediction rule. Acad Radiol. 1996 Feb;3(2):103–9.

Villar-Centeno LA, Díaz-Quijano FA, Martínez-Vega RA. Biochemical alterations as markers of dengue hemorrhagic fever. Am J Trop Med Hyg. 2008 Mar;78(3):370–4.

Martina BEE, Koraka P, Osterhaus ADME. Dengue virus pathogenesis: an integrated view. Clin Microbiol Rev. 2009 Oct;22(4):564–81.

Guilarde AO, Turchi MD, Jr. JBS, Feres VCR, Rocha B, Levi JE, et al. Dengue and Dengue Hemorrhagic Fever among Adults: Clinical Outcomes Related to Viremia, Serotypes, and Antibody Response. J Infect Dis. 2008 Mar 15;197(6):817–24.


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