Role of Serum Ferritin as a prognosticating tool in the course of Dengue fever

Abstract

BACKGROUND: Dengue is the most significant mosquito-borne viral disease in the world. Identification of the disease along with initiation of care is crucial if disease-related morbidity and mortality are to be reduced. These deaths could be prevented by early prediction of the course of the disease and early interventions. Apart from diagnostic testing for the detection of dengue fever, serum ferritin level found to be high in dengue fever. Hyperferritinemia is associated with immune activation and coagulation disturbances. A rise in serum ferritin level has been observed to have a linear correlation with severity of dengue fever. MATERIALS AND METHODS: A total of 38 patients admitted under general medicine in Yenepoya Medical College and hospital, Mangalore, Karnataka, and who has been diagnosed with dengue fever, confirmed by Dengue IgM ELISA were taken and their serum levels of ferritin were measured. RESULTS AND OBSERVATIONS: Total of 38 dengue cases were studied out of them, 18 had mild dengue ,14 had Dengue with warning signs and 6 were severe dengue. Mean serum ferritin value in the study was 718.5+/-355.8 and with range of 36 to1000ng/ml. As the severity of dengue increased there was increase in the serum ferritin level (P value < 0.05). Serum ferritin of 714 was considered as the cut off value for differentiation of the severe dengue from mild dengue and dengue with warning signs. CONCLUSION: In this study, the ROC curve was used to calculate the cut of value with highest sensitivity. Serum ferritin of 714 was considered as the cut off value for differentiation of the severe dengue from mild dengue and dengue with warning signs. There was statistically significant association of ferritin with severity of dengue, as the severity increases there is increase in serum ferritin. Thus we conclude that Serum ferritin is a reliable predictor of the dengue fever with a sensitivity of 100%  and Specificity of 43.75%. Thus the study results suggest that serum ferritin can be used as a prognosticating tool in the course of dengue fever.