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Ferritin levels predict severe dengue

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Abstract

Purpose

Currently, no tests are available to monitor and predict severity and outcome of dengue. To find potential markers that predict dengue severity, the present study validated the serum level of three acute-phase proteins α-1 antitrypsin, ceruloplasmin and ferritin in a pool of severe dengue cases compared to non-severe forms and other febrile illness controls.

Methods

A total of 96 patients were divided into two equal groups with group ‘A’ comprising dengue-infected cases and group ‘B’ with other febrile illness cases negative for dengue. Out of 48 dengue-infected cases, 13 had severe dengue and the remaining 35 were classified as non-severe dengue. Immunoassays were performed to evaluate the serum levels of acute-phase proteins both on the day of admission and on the day of defervescence. The efficiency of individual proteins in predicting the disease severity was assessed using receiver operating characteristic curve.

Results

The study did not find any significant difference in the levels of α-1 antitrypsin between the clinical groups. A significant increase in the levels of ceruloplasmin around defervescence in severe cases compared to non-severe and other febrile controls was observed and this is the first report describing the potential association of ceruloplasmin and dengue severity. Interestingly, a steady increase in the level of serum ferritin was recorded throughout the course of illness. Among all the three proteins, the elevated ferritin level could predict the disease severity with highest sensitivity and specificity of 76.9 and 83.3 %, respectively, on the day of admission and the same was found to be 90 and 91.6 % around defervescence.

Conclusion

On the basis of this diagnostic efficiency, we propose that ferritin may serve as a potential biomarker for an early prediction of disease severity.

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Acknowledgments

The authors acknowledge Dr. Narayanan P (Dept. of paediatrics), Dr. Kadhiravan T (Dept. of medicine), and Dr. SujathaS (Dept. of Microbiology) for providing clinical description of patients. This work was supported by intramural Grant from Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) and Prof. TRR Research grant, SASTRA University.

Conflict of interest

None declared.

Ethical standard

The study has been approved by institute ethics committee and informed written consent has been obtained from the participants involved in the study.

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Authors and Affiliations

  1. Department of Biochemistry, JIPMER, Pondicherry, 605 006, India

    R. Soundravally, M. Daisy, J. Sherin & C. C. Cleetus

  2. Centre for Research on Infectious Diseases (CRID), School of Chemical and Biotechnology, SASTRA University, Thanjavur, 613 401, Tamil Nadu, India

    B. Agieshkumar

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  1. R. Soundravally
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  2. B. Agieshkumar
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  3. M. Daisy
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  4. J. Sherin
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  5. C. C. Cleetus
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Corresponding authors

Correspondence to R. Soundravally or B. Agieshkumar.

Additional information

R. Soundravally and B. Agieshkumar are equally contributed authors.

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Soundravally, R., Agieshkumar, B., Daisy, M. et al. Ferritin levels predict severe dengue. Infection 43, 13–19 (2015). https://doi.org/10.1007/s15010-014-0683-4

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  • DOI: https://doi.org/10.1007/s15010-014-0683-4

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