Serum Ferritin Level as a Predictor of Disease Severity in Patients with Dengue Infection

Abstract

Background: Dengue infection is a major public health threat. The clinical spectrum of dengue infection is variable from mild fever to severe forms. Early laboratory diagnosis of dengue fever is important to provide appropriate treatment to the patients and to prevent potential complications. Although there are various biomarkers to predict the severity of dengue, they are not routinely used in clinical practice for prognostication. This study evaluated the performance of serum ferritin to predict the severity of dengue at an earlier stage as it is an inexpensive and easily accessible biomarker. Methods: Total 62 patients with diagnosis of dengue fever were enrolled after final selection. Serum ferritin levels of all the patients were measured on the day of admission. Patients were then divided into two groups on the basis of ferritin level. Group A comprising those with normal level and those having raised level were included in group B. Patients were then regularly followed up both clinically and biochemically during their hospital stay to see disease progression. Discharge from the hospital without complications or death of the patient during the hospital stay was the end point of the study. Every patient was managed according to the National Guideline for Clinical Management of Dengue Syndrome. Results: Most of the respondents (58.1%) belonged to the age group of 18-30 years with male predominance (69.4%). A significant association was found between the BMI of respondents & the groups (p<0.05). Highly significant association was reported among mucosal bleed (37.1%), clinical fluid accumulation (29.0%) & liver enlargement (30.6%) with ferritin level (p<0.001). A positive correlation was found between serum ferritin & hematocrit level of the respondents (r=0.719; p<0.001) and a negative correlation was found between serum ferritin & platelet level of the respondents (r= -0.857; p<0.001), both of which were highly significant. Patients with high level of ferritin .