Related Experiment Video
Updated: Jul 10, 2026
Ferritinophagy: Assessing the Selective Degradation of Iron by Autophagy in Human Fibroblasts
Published on: February 23, 2024
Hyperferritinemia in hospitalized children with dengue-a prospective observational study
Liya Varghese1, Abhijit Choudhary2, Megha Jayachandran2
1All India Institute of Medical Sciences, Nagpur, Maharashtra, 441124, India.
Insights
Hyperferritinemia is common in hospitalized children with dengue, especially severe dengue. High ferritin levels correlate with lower platelet counts and increased organ dysfunction, indicating its potential as a severity biomarker.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Biochemistry
- Biomarker Research
Background:
- Dengue is a significant cause of pediatric hospitalization in low- and middle-income countries (LMICs).
- Early recognition of severe dengue is challenging, necessitating reliable biomarkers.
- Ferritin, an acute-phase reactant, is under investigation for its role in dengue severity.
Purpose of the Study:
- To determine the prevalence of hyperferritinemia in children hospitalized with dengue with warning signs and severe dengue.
- To correlate ferritin levels with clinical outcomes such as organ dysfunction and thrombocytopenia.
- To evaluate ferritin as a potential biomarker for severe dengue in pediatric populations in LMICs.
Main Methods:
- A prospective observational study was conducted over 6 months.
- 52 children (1 month-18 years) admitted with dengue with warning signs or severe dengue were enrolled.
- Serum ferritin levels were measured at admission, alongside demographic, clinical, and laboratory data collection.
Main Results:
- Hyperferritinemia was prevalent, seen in 61.9% of children with warning signs and 90% with severe dengue.
- Children with ferritin levels ≥3000 μg/l exhibited significantly lower platelet counts and increased hematological and respiratory dysfunction.
- Higher ferritin levels were associated with a greater proportion of severe dengue cases.
Conclusions:
- Hyperferritinemia is common in hospitalized children diagnosed with dengue.
- Elevated ferritin levels are significantly associated with thrombocytopenia and organ dysfunction in pediatric dengue.
- Ferritin shows promise as a valuable biomarker for assessing dengue severity in children, particularly in resource-limited settings.
Abstract:
Dengue is a major cause of pediatric hospitalization in tropical countries and low- and middle-income countries (LMICs), where early recognition of severe disease remains challenging. Severe dengue is characterized by dysregulated immune activation and systemic inflammation, leading to organ dysfunction. Ferritin, an acute-phase reactant, has been increasingly studied as a potential biomarker of dengue severity, although pediatric data from LMIC settings remain limited. The aim of this study was to assess the prevalence of hyperferritinemia among children admitted with dengue with warning signs and severe dengue, and to correlate ferritin levels with clinical outcomes including organ dysfunction, new-onset multiple organ dysfunction syndrome, thrombocytopenia, need for ventilation, pediatric intensive care unit (PICU) admission, and duration of hospital stay. This single-center prospective observational study included children aged 1 month-18 years admitted to the pediatric ward or PICU with dengue with warning signs or severe dengue over a 6-month period. Serum ferritin was measured at admission. Demographic, clinical, and laboratory data were collected and analyzed. Among the 52 enrolled children, 42 (80.8%) had dengue with warning signs and 10 (19.2%) had severe dengue. Hyperferritinemia was observed in 26/42 (61.9%) children with warning signs and in 9/10 (90%) children with severe dengue. When stratified using a ferritin cutoff of 3000 μg/l, children with ferritin ≥3000 μg/l had significantly lower platelet counts during hospital stay (P-value = .004), increased hematological (P-value = .002) and respiratory dysfunction (P-value = .044), and a higher proportion of severe dengue cases (P-value = .01). Hyperferritinemia is common among hospitalized children with dengue and is associated with thrombocytopenia and organ dysfunction, supporting ferritin as a marker of disease severity.
