Asian-Oceanian Journal of Pediatrics and Child Health

Volume Three December 2004 Number Two

PATHOGENESIS OF DENGUE SHOCK SYNDROME: IMMUNE ENHANCEMENT OR VIRAL VIRULENCE

Olarn Prommalikit, M.D.1,
Chitsanu Pancharoen, M.D.2
Ananda Nisalak, M.D.3
Usa Thisyakorn M.D.2
Chule Thisyakorn, M.D.2

1. Department of Pediatrics, Faculty of Medicine, Srinakharinwirot
   University, Nakorn-nayok, Thailand

2. Department of Pediatrics, Faculty of Medicine, Chulalongkorn
   University, Bangkok, Thailand

3. Armed Forces Research Institute of Medical Sciences (AFRIMS),
   Bangkok, Thailand
   

Corresponding Author:

OLARN PROMMALIKIT, M.D.
Infectious Diseases Unit, Department of Pediatrics,
Faculty of Medicine, Srinakharinwirot University
Rungsit-Ongkarax Road, Ongkarax,
Nakorn-nayok 26120, Thailand
Tel. (66-37) 395085-8 ext 10901
Fax. (66-37) 395275
E-mail: drolarnp2002@yahoo.com


ABSTRACT

Background:

The pathogenesis of dengue hemorrhagic fever (DHF) and dengue shock
syndrome (DSS) is not clearly understood. Two hypotheses i.e. immune enhancement and viral virulence have been debated.

Objective:

To study the correlation between dengue serotypes, serologic responses,
and disease severity.

Materials & Methods:

We enrolled children who were clinically and serologically diagnosed as dengue virus infection and were admitted to King Chulalongkorn Memorial Hospital, Bangkok, Thailand, during a period of one year. They were clinically classified as non-shock (dengue fever, DHF grade I & II) and shock (DHF grade III & IV), and
were serologically classified as primary and secondary infections. Viral isolation was done and serotypes of dengue virus were identified. Chi-square test and analysis of variance were used for statistical analysis.

Results:

Dengue virus was isolated from 120 out of 555 children (21.6%). Of these, 73 (60.8%) were classified into non-shock group and 47 (39.2%) were classified into shock group. Primary and secondary dengue infections were found in 26 (21.7%) and 94
(78.7%) respectively. Patients with secondary infection developed shock more often than those with primary infection (47.9% vs 7.7%, p < 0.05). Common serotypes of dengue virus (DEN) isolated were DEN-2 (30.8%) and DEN-3 (60.8%). Patients infected with DEN-2 developed shock more often than those infected with DEN-3 and DEN-1, (56.8% vs 32.9% vs 20.0%, p < 0.05). After using logistic regression analysis, serologic response was the only risk factor for the disease severity.

Conclusions:

This study supported that immune enhancement plays an important role in pathogenesis of DSS.

Key words: Dengue virus, Immune enhancement, Viral Virulence, Shock, DSS.

Information

Information for Authors

Subscription

Latest Journal

Volume Three December 2004 Number Two

Previous Issues

Updated July 2006

All logos and trademarks at this site are properties of their respective owners.
All contents and information herein are © 2006 appassoc.org