Chymase level is a predictive biomarker of dengue hemorrhagic fever in pediatric and adult patients
H Tissera, APS Rathore, WY Leong… - The Journal of …, 2017 - academic.oup.com
The Journal of infectious diseases, 2017•academic.oup.com
Background Most patients with dengue experience mild disease, dengue fever (DF), while
few develop the life-threatening diseases dengue hemorrhagic fever (DHF) or dengue shock
syndrome (DSS). No laboratory tests predict DHF or DSS. We evaluated whether the serum
chymase level can predict DHF or DSS in adult and pediatric patients and the influence of
preexisting conditions (PECs) on chymase levels. Methods Serum chymase levels were
measured in patients presenting with undifferentiated fever to hospitals in Colombo District …
few develop the life-threatening diseases dengue hemorrhagic fever (DHF) or dengue shock
syndrome (DSS). No laboratory tests predict DHF or DSS. We evaluated whether the serum
chymase level can predict DHF or DSS in adult and pediatric patients and the influence of
preexisting conditions (PECs) on chymase levels. Methods Serum chymase levels were
measured in patients presenting with undifferentiated fever to hospitals in Colombo District …
Background
Most patients with dengue experience mild disease, dengue fever (DF), while few develop the life-threatening diseases dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). No laboratory tests predict DHF or DSS. We evaluated whether the serum chymase level can predict DHF or DSS in adult and pediatric patients and the influence of preexisting conditions (PECs) on chymase levels.
Methods
Serum chymase levels were measured in patients presenting with undifferentiated fever to hospitals in Colombo District, Sri Lanka. The value of serum the chymase concentration and clinical signs and symptoms as predictors of DHF and/or DSS was evaluated by multivariate analysis. We assessed the influence of age, PECs, and day after fever onset on the robustness of the chymase level as a biomarker for DHF and/or DSS.
Results
An elevated chymase level in acute phase blood samples was highly indicative of later diagnosis of DHF or DSS for pediatric and adult patients with dengue. No recorded PECs prevented an increase in the chymase level during DHF. However, certain PECs (obesity and cardiac or lung-associated diseases) resulted in a concomitant increase in chymase levels among adult patients with DHF.
Conclusions
These results show that patients with acute dengue who present with high levels of serum chymase consistently are at greater risk of DHF. The chymase level is a robust prognostic biomarker of severe dengue for adult and pediatric patients.
Oxford University Press