Proteinuria and gall bladder wall thickness as predictive indicators for dengue severity in pediatric patients

Area of Science:

• Pediatric Infectious Diseases
• Clinical Diagnostics
• Biomarker Research

Background:

• Dengue is a significant mosquito-borne viral illness in children, with severe forms leading to complications like capillary leakage and organ dysfunction.
• Early detection of severe dengue is critical for timely intervention and improved patient outcomes.
• Noninvasive markers are needed for efficient and accessible assessment of disease severity in pediatric dengue.

Purpose of the Study:

• To evaluate the predictive value of urine albumin-creatinine ratio (UACR) and gall bladder wall thickness (GBWT) for disease severity in pediatric dengue.
• To assess the association of UACR and GBWT with laboratory parameters and mortality outcomes in children with dengue.

Main Methods:

• A prospective observational study included 74 children (6 months to 12 years) with moderate to severe dengue (WHO 2009 classification).
• Urine albumin-creatinine ratio (UACR) was measured from spot urine samples.
• Gall bladder wall thickness (GBWT) was assessed using abdominal ultrasound between days 3 and 6 of fever.

Main Results:

• Mean UACR and GBWT were significantly higher in severe dengue cases compared to moderate cases (P < 0.001 for UACR, P = 0.035 for GBWT).
• Elevated UACR and increased GBWT correlated with higher mortality and poorer outcomes.
• Combined UACR and GBWT showed a high odds ratio (13.3) for predicting severe dengue.

Conclusions:

• UACR and GBWT serve as valuable noninvasive adjuncts for predicting dengue severity and mortality in children.
• These markers can support early identification, triage, and management strategies for pediatric dengue.
• Further research may refine the utility of UACR and GBWT in clinical practice for dengue management.