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Hyperferritinemia in Severe Dengue Infection: Single-Center Retrospective Cohort Study
Chidhambharam Lakshmanan1, Suchitra Ranjit1, Rajeswari Natraj1
1Department of Pediatric ICU, Apollo Children's Hospital, Chennai, India.
Summary
Hyperferritinemia, a marker of severe dengue, correlates with disease severity criteria. Many children with severe dengue recover with supportive care, showing improved outcomes as ferritin levels decrease.
Area of Science:
- Pediatric Infectious Diseases
- Critical Care Medicine
- Hematology
Background:
- Hyperferritinemia is observed during the critical phase of dengue infections.
- Its correlation with severe dengue (sd) disease requires further investigation.
Purpose of the Study:
- To examine the association between ferritin levels on Pediatric Intensive Care Unit (PICU) admission and the 2009 World Health Organization (WHO) criteria for severe dengue.
- To evaluate patient outcomes in relation to care received.
Main Methods:
- A retrospective cohort study included 55 children (1 month to 16 years) admitted to the PICU with dengue and ferritin levels ≥500 ng/mL.
- Data analyzed included demographics, clinical and laboratory parameters, WHO sd criteria, and outcomes.
- Immunomodulatory therapy was administered for persistent hyperinflammation beyond the critical phase.
Main Results:
- Median ferritin levels were 8,105 ng/mL in the critical phase of dengue.
- Patients meeting WHO sd criteria had higher ferritin levels, with the highest in those meeting all three criteria.
- 94% of patients recovered with supportive care, with recovery linked to decreasing ferritin levels.
Conclusions:
- Hyperferritinemia in severe dengue is associated with the number of WHO sd criteria present.
- The study indicates that many patients with severe dengue can recover effectively with standard supportive care.
