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Ng AWW, Mi HF, Ho SL, Teoh SCB, Agrawal R. Ocular Autoimmune Systemic Inflammatory Infectious Study (OASIS) - Report 6: Dengue Uveitis at a Tertiary Eye Institution in Singapore. Ocul Immunol Inflamm 2024; 32:184-189. [PMID: 36607816 DOI: 10.1080/09273948.2022.2159840] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To identify the characteristics, treatment, and visual outcomes of dengue uveitis at a tertiary eye care centre in Singapore. METHODS Retrospective case record review of all consecutive dengue uveitis patients (2004 to 2015) from the Ocular Autoimmune Systemic Inflammatory and Infectious Study (OASIS) database. RESULTS Fifty-four patients were identified from the OASIS database. The most common ocular symptom was blurring of vision (n = 41, 75.9%), followed by floaters (n = 9, 17.0%), scotoma (n = 5, 9.3%), and metamorphopsia (n = 3, 5.7%). Scotoma based on history, Amsler grid, and perimetry accounted for 27 (50%) patients. Majority presented with either a posterior uveitis or retinal vasculitis (n = 51, 94.4%). Treatments ranged from close observation for spontaneous improvement, to the use of high-dose corticosteroids. CONCLUSIONS Dengue uveitis may present with a spectrum of disease manifestations including posterior uveitis, vasculitis, and macula edema. Scotoma is significant and may be found on history taking, Amsler charting, and perimetry.
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Affiliation(s)
- Aaron Wei Wen Ng
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | - Helen Fang Mi
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | - Su Ling Ho
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | - Stephen Charn Beng Teoh
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
- Eagle Eye Center, Singapore
| | - Rupesh Agrawal
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
- Duke-NUS Medical School, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Singapore Eye Research Institute, Singapore
- National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital, London, UK
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Xie Cen A, Ng AWW, Rojas-Carabali W, Cifuentes-González C, de-la-Torre A, Mahendradas P, Agrawal R. Dengue Uveitis - A Major Review. Ocul Immunol Inflamm 2023; 31:1440-1453. [PMID: 37315302 DOI: 10.1080/09273948.2023.2220020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/22/2023] [Accepted: 05/26/2023] [Indexed: 06/16/2023]
Abstract
Dengue fever is a significant global public health concern with increasing incidence over the past two decades. The symptoms range from mild to severe, including fever, headache, rash, and joint pain. Ocular complications are prevalent among hospitalized patients, estimated to be between 10% and 40.3%, with varying incidences based on the serotype and severity of dengue. These complications can be hemorrhagic or inflammatory and typically occur after the onset of fever. Modern diagnostic tools such as Optical Coherence Tomography (OCT) and Fundus Fluorescein Angiography (FFA) have enabled physicians to better understand the extent of ocular involvement and guide treatment. This article provides an updated overview of the various manifestations of dengue uveitis, including their diagnosis and treatment.
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Affiliation(s)
- Amy Xie Cen
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Aaron Wei Wen Ng
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | - William Rojas-Carabali
- Neuroscience Research Group (NEUROS), Neurovitae Center for Neuroscience, Institute of Translational Medicine (IMT), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
- Advanced Ophthalmic Imaging Laboratory, Department of Ophthalmology, New York University School of Medicine, New York, New York, USA
| | - Carlos Cifuentes-González
- Neuroscience Research Group (NEUROS), Neurovitae Center for Neuroscience, Institute of Translational Medicine (IMT), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Alejandra de-la-Torre
- Neuroscience Research Group (NEUROS), Neurovitae Center for Neuroscience, Institute of Translational Medicine (IMT), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | | | - Rupesh Agrawal
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
- Duke-NUS Medical School, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Singapore Eye Research Institute, Singapore
- National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital, London, UK
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3
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Mbu-Nyamsi D, Vincent M, Perez-Fontana M, Best AL, Mesnard C, Villeroy F, Foucher A, Raffray L, Terrier CSP, Bertolotti A. Ophthalmic complications during the dengue epidemic in Reunion Island in 2020: a case series and review of the literature. BMC Infect Dis 2023; 23:506. [PMID: 37528344 PMCID: PMC10394947 DOI: 10.1186/s12879-023-08432-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 06/28/2023] [Indexed: 08/03/2023] Open
Abstract
INTRODUCTION Dengue is an arboviral disease transmitted by the dengue virus, whose vectors are Aedes aegypti and Aedes albopictus. The acute phase with its cohort of well-known symptoms is usually spontaneously favorable. Since 2020 in Reunion Island, a new symptom has appeared: the ocular damage of dengue fever, which has already been described in South Asia and South-East Asia. We therefore decided to describe the clinical, biological, ophthalmological, therapeutic, and outcomes of patients with ocular manifestations during dengue fever in Reunion Island in 2020. PATIENTS AND METHODS This was a retrospective observational study. Patients were included from January 2020 to August 2020 and then reassessed by teleconsultation 1 year later. The patients were identified from the French public health surveillance network by all ophthalmologists on the island. Medical data were collected directly from medical records. RESULTS Twenty-eight patients were included. The mean age was 41.9 years. Ocular involvement occurred approximately 9.2 days after the onset of dengue symptoms. The main symptoms were scotoma (71.4%) and sudden decrease of visual acuity (39.2%). Eighteen patients (64.2%) had macular involvement. Fourteen patients were treated with oral or intravenous corticosteroids. Twenty-two (78.5%) patients were evaluated by telephone one year later. Scotoma and decreased visual acuity persisted in 15 patients. Thirteen patients (59%) were bothered by night driving, 32% of patients had reading difficulties and 27% of patients became sensitive to prolonged exposure to screens. CONCLUSION Ocular complications of dengue require early and collegial management to limit the risk of long-term sequelae. Further studies on the characteristics and complications of dengue fever are needed to better understand this disease.
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Affiliation(s)
- Digé Mbu-Nyamsi
- Département de maladies infectieuses-médecine interne-dermatologie, CHU de La Réunion, Saint Pierre, La Réunion, France
| | - Muriel Vincent
- Santé Publique France, Océan Indien, Saint Denis, La Réunion, France
| | | | - Anne-Laurence Best
- Département d'ophtalmologie, CHU de La Réunion, Saint Pierre, La Réunion, France
| | - Charles Mesnard
- Département d'ophtalmologie, CHOR, Saint Paul, La Réunion, France
| | - Fréderic Villeroy
- Département d'ophtalmologie, CHU de La Réunion, Saint Denis, La Réunion, France
| | - Aurélie Foucher
- Département de maladies infectieuses-médecine interne-dermatologie, CHU de La Réunion, Saint Pierre, La Réunion, France
| | - Loic Raffray
- Département de médecine interne, CHU de La Réunion, Saint Denis, La Réunion, France
- Unité Mixte de Recherche Processus Infectieux en Milieu Insulaire Tropical (PIMIT), Université de La Réunion, INSERM UMR 1187, CNRS 9192, IRD 249, Plateforme CYROI, Sainte Clotilde, La Réunion, France
| | - Cécile Saint-Pastou Terrier
- Département de maladies infectieuses-médecine interne-dermatologie, CHU de La Réunion, Saint Pierre, La Réunion, France
| | - Antoine Bertolotti
- Département de maladies infectieuses-médecine interne-dermatologie, CHU de La Réunion, Saint Pierre, La Réunion, France.
- CHU de La Réunion, CIC-INSERM1410, Saint Pierre, La Réunion, France.
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Panophthalmitis in Patient With Dengue Hemorrhagic Fever. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2023. [DOI: 10.1097/ipc.0000000000001233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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5
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Tam DTH, Clapham H, Giger E, Kieu NTT, Nam NT, Hong DTT, Nuoi BT, Cam NTH, Quyen NTH, Turner HC, Jaenisch T, Simmons CP, Lam PK, Wills B. Burden of Postinfectious Symptoms after Acute Dengue, Vietnam. Emerg Infect Dis 2023; 29:160-163. [PMID: 36573590 PMCID: PMC9796196 DOI: 10.3201/eid2901.220838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
We assessed predominantly pediatric patients in Vietnam with dengue and other febrile illness 3 months after acute illness. Among dengue patients, 47% reported >1 postacute symptom. Most resolved by 3 months, but alopecia and vision problems often persisted. Our findings provide additional evidence on postacute dengue burden and confirm children are affected.
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Wagle AM, Hegde SR, Sanjay S, Au Eong KG. Ophthalmic manifestations in seropositive dengue fever patients during epidemics caused by predominantly different dengue serotypes. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2022; 2:100049. [PMID: 37846383 PMCID: PMC10577814 DOI: 10.1016/j.aopr.2022.100049] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/02/2022] [Accepted: 04/06/2022] [Indexed: 10/18/2023]
Abstract
Purpose Dengue fever (DF) epidemics in Singapore in 2005-2006 and 2007 were caused predominantly by dengue virus serotypes 1 (DENV-1) and 2 (DENV-2) respectively. We investigated the prevalence of ophthalmic manifestations during these consecutive epidemics. Methods Seropositive DF patients admitted to the hospital during two separate dengue epidemics were enrolled from June 2005 to December 2007. Demographic, ophthalmic, and laboratory data were collected. The primary outcome measures were differences in ophthalmic and laboratory features across the two epidemics. Factors associated with increased risk of developing various DF-related ophthalmic manifestations were the secondary outcome measures. Results Of the 115 patients enrolled, 109 (94.7%; 33 in 2005-2006 and 76 in 2007) completed the eye screening protocol. Majority of patients were Chinese (65, 59.6%) and males (81, 74.3%). The mean age was 40.8 years (range, 18-87). Colour vision impairment (12 vs 14 [36.4% vs 18.7%]; P = 0.04), cotton wool spots (10 vs 3 [30.3% vs 3.9%]; P < 0.001), bleeding diathesis (7 vs 3 [21.2% vs 3.9%]; P = 0.004) and abnormal liver function (mean alanine amino-transferase [150.2 U/L vs 68.28 U/L; P = 0.001], mean aspartate amino-transferase [196.86 U/L vs 99.53 U/L; P = 0.002], total protein [68.43 g/L vs 72.27 g/L; P = 0.016], serum albumin [36.86 g/L vs 40.5 g/L; P = 0.001]) were noted more often in DF epidemics predominantly caused by DENV-1 compared to DENV-2. Conclusions A higher prevalence of colour vision impairment, cotton wool spots, bleeding diathesis, and abnormal liver function was found in DF epidemics predominantly caused by DENV-1 compared to DENV-2.
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Affiliation(s)
- Ajeet M. Wagle
- International Eye Cataract Retina Centre, Mount Elizabeth Medical Centre, Singapore
- International Eye Cataract Retina Centre, Farrer Park Medical Centre, Singapore
- Khoo Teck Puat Hospital, Singapore
- Alexandra Hospital, Singapore
| | - Smita R. Hegde
- Alexandra Hospital, Singapore
- Shree Shantinath Medical Trust – Jain Hospital, Mumbai, India
| | | | - Kah-Guan Au Eong
- International Eye Cataract Retina Centre, Mount Elizabeth Medical Centre, Singapore
- International Eye Cataract Retina Centre, Farrer Park Medical Centre, Singapore
- Khoo Teck Puat Hospital, Singapore
- Alexandra Hospital, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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Tiga-Loza DC, Martínez-Vega RA, Undurraga EA, Tschampl CA, Shepard DS, Ramos-Castañeda J. Persistence of symptoms in dengue patients: a clinical cohort study. Trans R Soc Trop Med Hyg 2021; 114:355-364. [PMID: 32125417 DOI: 10.1093/trstmh/traa007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 01/14/2020] [Accepted: 01/16/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dengue is commonly considered an acute illness and follows three phases: febrile, critical in some cases and recovery. However, a number of studies have described a continuation of dengue symptoms for weeks or months, extending the recovery phase. Here we evaluate this persistence of dengue symptoms during convalescence. METHODS Our clinical cohort study included patients who sought medical services 48 to 144 h from the onset of fever at seven hospitals or ambulatory centers in Morelos, Mexico. Seventy-nine laboratory-confirmed dengue patients were followed up regularly using clinic and/or home visits and telephone calls for as long as symptoms persisted or up to 6 mo. RESULTS In total, 55.7% of patients had dengue-related symptoms 1 mo after the onset of fever; pain and dermatological manifestations were the most common persistent symptoms. Prognostic factors for symptom persistence were: ≥4 d of fever (RR 1.72; 95% CI 1.35 to 2.19), platelet count ≤100 000/mm3 (RR 1.20; 95% CI 1.20 to 2.20), petechiae/bruises (RR 1.97; 95% CI 1.56 to 2.48) and abdominal pain/hepatomegaly (RR 1.79; 95% CI 1.41 to 2.28). CONCLUSIONS Persistence of dengue symptoms were common in laboratory-confirmed dengue patients. Manifestations related to tissue damage were associated with persistence after 30 d; host characteristics, such as age and health status before infection, were associated with prolonged persistence (>60 d). The burden of dengue may be higher than previously estimated.
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Affiliation(s)
- Diana Carolina Tiga-Loza
- Programa de enfermería, Universidad Manuela Beltrán, Bucaramanga, Santander, Colombia.,Centro de investigaciones sobre enfermedades infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Ruth A Martínez-Vega
- Escuela de Microbiología, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia
| | - Eduardo A Undurraga
- Escuela de Gobierno, Pontificia Universidad Católica de Chile, Santiago, Chile.,Millennium Nucleus for the Study of the Life Course and Vulnerability (MLIV), Chile
| | - Cynthia A Tschampl
- Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, Massachusetts, USA
| | - Donald S Shepard
- Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, Massachusetts, USA
| | - José Ramos-Castañeda
- Centro de investigaciones sobre enfermedades infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.,Universidad Anahuac, Centro de Investigación en Ciencias de la Salud. México
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Naik S, Robinson ML, Alexander M, Chandanwale A, Sambarey P, Kinikar A, Bharadwaj R, Sapkal GN, Chebrolu P, Deshpande P, Kulkarni V, Nimkar S, Mave V, Gupta A, Mathad J. Intensified Short Symptom Screening Program for Dengue Infection during Pregnancy, India. Emerg Infect Dis 2020; 26:738-743. [PMID: 32186485 PMCID: PMC7101120 DOI: 10.3201/eid2604.191476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Mosquitoborne diseases (e.g., malaria, dengue, and chikungunya) are endemic to India and pose diagnostic challenges during pregnancy. We evaluated an intensified short symptom screening program in India to diagnose dengue during pregnancy. During October 2017–January 2018, we screened pregnant women during antenatal surveillance for symptoms of mosquitoborne diseases (fever only, fever with conjunctivitis, fever with rash, or all 3 symptoms) within the previous 15 days. Of 5,843 pregnant women screened, 52 were enrolled and tested for dengue, chikungunya, and Zika viruses by using a Trioplex real-time reverse transcription PCR. Of 49 who had complete results, 7 (14%) were dengue positive. Of these ocular pain was seen in 4 (57%) and conjunctivitis in 7 (100%). Intensified symptom screening using conjunctivitis, in addition to rash, in pregnant women with fever might improve dengue case detection and can be included in routine symptom screening during pregnancy.
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Abstract
Dengue virus (DENV) belongs to the family Flaviviridae, genus Flavivirus. It is a single-stranded positive-sense ribonucleic acid virus with 10,700 bases. The genus Flavivirus includes other arthropod borne viruses such as yellow fever virus, West Nile virus, Zika virus, tick-borne encephalitis virus. It infects ~50–200 million people annually, putting over 3.6 billion people living in tropical regions at risk and causing ~20,000 deaths annually. The expansion of dengue is attributed to factors such as the modern dynamics of climate change, globalization, travel, trade, socioeconomics, settlement, and also viral evolution. There are four antigenically different serotypes of DENV based on the differences in their viral structural and nonstructural proteins. DENV infection causes a spectrum of illness ranging from asymptomatic to dengue fever to severe dengue shock syndrome. Infection with one serotype confers lifelong immunity against that serotype, but heterologus infection leads to severe dengue hemorrhagic fever due to antibody-dependent enhancement. Diagnosis of dengue infections is based mainly on serological detection of either antigen in acute cases or antibodies in both acute and chronic infection. Viral detection and real-time PCR detection though helpful is not feasible in resource poor setup. Treatment of dengue depends on symptomatic management along with fluid resuscitation and may require platelet transfusion. Although vaccine development is in late stages of development, developing a single vaccine against four serotypes often causes serious challenges to researchers; hence, the main stay of prevention is vector control and management.
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10
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Singh S, Kumar A. Ocular Manifestations of Emerging Flaviviruses and the Blood-Retinal Barrier. Viruses 2018; 10:v10100530. [PMID: 30274199 PMCID: PMC6213219 DOI: 10.3390/v10100530] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 12/19/2022] Open
Abstract
Despite flaviviruses remaining the leading cause of systemic human infections worldwide, ocular manifestations of these mosquito-transmitted viruses are considered relatively uncommon in part due to under-reporting. However, recent outbreaks of Zika virus (ZIKV) implicated in causing multiple ocular abnormalities, such as conjunctivitis, retinal hemorrhages, chorioretinal atrophy, posterior uveitis, optic neuritis, and maculopathies, has rejuvenated a significant interest in understanding the pathogenesis of flaviviruses, including ZIKV, in the eye. In this review, first, we summarize the current knowledge of the major flaviviruses (Dengue, West Nile, Yellow Fever, and Japanese Encephalitis) reported to cause ocular manifestations in humans with emphasis on recent ZIKV outbreaks. Second, being an immune privilege organ, the eye is protected from systemic infections by the presence of blood-retinal barriers (BRB). Hence, we discuss how flaviviruses modulate retinal innate response and breach the protective BRB to cause ocular or retinal pathology. Finally, we describe recently identified infection signatures of ZIKV and discuss whether these system biology-predicted genes or signaling pathways (e.g., cellular metabolism) could contribute to the pathogenesis of ocular manifestations and assist in the development of ocular antiviral therapies against ZIKV and other flaviviruses.
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Affiliation(s)
- Sneha Singh
- Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University, Detroit, MI 48201, USA.
| | - Ashok Kumar
- Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University, Detroit, MI 48201, USA.
- Department of Biochemistry, Microbiology, and Immunology, Wayne State University, Detroit, MI 48201, USA.
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Zaidi MB, De Moraes CG, Petitto M, Yepez JB, Sakuntabhai A, Simon-Loriere E, Prot M, Ruffie C, Kim SS, Allikmets R, Terwilliger JD, Lee JH, Maestre GE. Non-congenital severe ocular complications of Zika virus infection. JMM Case Rep 2018; 5:e005152. [PMID: 30128159 PMCID: PMC6096927 DOI: 10.1099/jmmcr.0.005152] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 04/23/2018] [Indexed: 01/03/2023] Open
Affiliation(s)
- Mussaret B. Zaidi
- Infectious Diseases Research Laboratory, Hospital General O'Horan, Merida, Mexico
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - C. Gustavo De Moraes
- Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA
| | | | - Juan B. Yepez
- Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Anavaj Sakuntabhai
- Functional Genetics of Infectious Diseases Unit, Institut Pasteur, Paris, France, CNRS, UMR2000, Paris, France
- Viral Genomics and Vaccination Unit, Institut Pasteur, Paris, France, CNRS, UMR 3965, Paris, France
| | - Etienne Simon-Loriere
- Functional Genetics of Infectious Diseases Unit, Institut Pasteur, Paris, France, CNRS, UMR2000, Paris, France
- Viral Genomics and Vaccination Unit, Institut Pasteur, Paris, France, CNRS, UMR 3965, Paris, France
| | - Matthieu Prot
- Functional Genetics of Infectious Diseases Unit, Institut Pasteur, Paris, France, CNRS, UMR2000, Paris, France
- Viral Genomics and Vaccination Unit, Institut Pasteur, Paris, France, CNRS, UMR 3965, Paris, France
| | - Claude Ruffie
- Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Viral Genomics and Vaccination Unit, Institut Pasteur, Paris, France, CNRS, UMR 3965, Paris, France
| | - Susan S. Kim
- In-patient Diabetes Unit, St Peter’s Hospital, Albany, NY, USA
| | - Rando Allikmets
- Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA
| | - Joseph D. Terwilliger
- Departments of Psychiatry and Genetics and Development, Columbia University Medical Center, New York, NY, USA
- Sergievsky Center, Columbia University Medical Center, New York, NY, USA
- Division of Medical Genetics, New York State Psychiatric Institute, New York, NY, USA
- Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Joseph H. Lee
- Sergievsky Center, Columbia University Medical Center, New York, NY, USA
- Taub Institute and Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
| | - Gladys E. Maestre
- Laboratory of Neuroscience, University of Zulia, Maracaibo, Venezuela
- Department of Biomedical Sciences, Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
- Department of Human Genetics, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
- *Correspondence: Gladys E. Maestre, or
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Gulati S, Gulati A, Patil M, Saxena R. Ocular manifestations of dengue fever. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2016. [DOI: 10.1016/j.injms.2016.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Goldhardt R, Patel H, Davis JL. Acute Posterior Multifocal Placoid Pigment Epitheliopathy Following Dengue Fever: A New Association for an Old Disease. Ocul Immunol Inflamm 2016; 24:610-614. [DOI: 10.3109/09273948.2015.1125513] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Raquel Goldhardt
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Heena Patel
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Janet L. Davis
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
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14
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Dengue eye disease. Surv Ophthalmol 2015; 60:106-14. [DOI: 10.1016/j.survophthal.2014.07.003] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 07/27/2014] [Accepted: 07/29/2014] [Indexed: 11/22/2022]
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15
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Gan VC. Dengue: Moving from Current Standard of Care to State-of-the-Art Treatment. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2014; 6:208-226. [PMID: 25999799 PMCID: PMC4431705 DOI: 10.1007/s40506-014-0025-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Treatment of dengue remains supportive in the absence of targeted antiviral therapy or approved vaccines. Responsive fluid management is key to preventing progression to shock or other severe manifestations. The dynamic natural history of dengue infection and its influence on hemodynamic homeostasis needs to be carefully considered in the planning of individualized therapy. Though largely self-limiting, the sheer burden of dengue disease on the global population will result in atypical manifestations especially in children, older adults, and comorbid patients. Management of these has not yet been systematized. The failure of recent randomized controlled trials to show utility for antiviral and immunomodulatory agents in dengue is disappointing. Vaccine candidates hold promise, but growing outbreaks require more robust, evidence-based management guidelines to inform clinicians, especially in novel epidemic situations.
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Affiliation(s)
- Victor C. Gan
- Institute of Infectious Disease and Epidemiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433 Singapore
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16
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Mishra A, Shukla S, Aggarwal S, Chaudhary B. Lateral rectus palsy in a case of dengue fever. Med J Armed Forces India 2013; 71:S101-3. [PMID: 26265797 DOI: 10.1016/j.mjafi.2013.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 05/28/2013] [Indexed: 11/19/2022] Open
Affiliation(s)
- Avinash Mishra
- Classified Specialist (Ophthalmology), Military Hospital, Ahmedabad, Gujarat, India
| | - Siddharth Shukla
- Graded Specialist (Medicine), Military Hospital, Ahmedabad, India
| | - Somesh Aggarwal
- Associate Professor, Vitero-Retinal Surgeon, M & J Western Regional Institute of Ophthalmology, Ahmedabad, India
| | - B Chaudhary
- Commandant, Military Hospital, Ahmedabad, India
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Shepard DS, Undurraga EA, Halasa YA. Economic and disease burden of dengue in Southeast Asia. PLoS Negl Trop Dis 2013; 7:e2055. [PMID: 23437406 PMCID: PMC3578748 DOI: 10.1371/journal.pntd.0002055] [Citation(s) in RCA: 281] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 12/26/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Dengue poses a substantial economic and disease burden in Southeast Asia (SEA). Quantifying this burden is critical to set policy priorities and disease-control strategies. METHODS AND FINDINGS We estimated the economic and disease burden of dengue in 12 countries in SEA: Bhutan, Brunei, Cambodia, East-Timor, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Viet Nam. We obtained reported cases from multiple sources--surveillance data, World Health Organization (WHO), and published studies--and adjusted for underreporting using expansion factors from previous literature. We obtained unit costs per episode through a systematic literature review, and completed missing data using linear regressions. We excluded costs such as prevention and vector control, and long-term sequelae of dengue. Over the decade of 2001-2010, we obtained an annual average of 2.9 million (m) dengue episodes and 5,906 deaths. The annual economic burden (with 95% certainty levels) was US$950m (US$610m-US$1,384m) or about US$1.65 (US$1.06-US$2.41) per capita. The annual number of disability-adjusted life years (DALYs), based on the original 1994 definition, was 214,000 (120,000-299,000), which is equivalent to 372 (210-520) DALYs per million inhabitants. CONCLUSION Dengue poses a substantial economic and disease burden in SEA with a DALY burden per million inhabitants in the region. This burden is higher than that of 17 other conditions, including Japanese encephalitis, upper respiratory infections, and hepatitis B.
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Affiliation(s)
- Donald S Shepard
- Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA.
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Daumas RP, Passos SRL, Oliveira RVC, Nogueira RMR, Georg I, Marzochi KBF, Brasil P. Clinical and laboratory features that discriminate dengue from other febrile illnesses: a diagnostic accuracy study in Rio de Janeiro, Brazil. BMC Infect Dis 2013; 13:77. [PMID: 23394216 PMCID: PMC3574824 DOI: 10.1186/1471-2334-13-77] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 02/04/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Dengue is an acute febrile illness caused by an arbovirus that is endemic in more than 100 countries. Early diagnosis and adequate management are critical to reduce mortality. This study aims to identify clinical and hematological features that could be useful to discriminate dengue from other febrile illnesses (OFI) up to the third day of disease. METHODS We conducted a sectional diagnostic study with patients aged 12 years or older who reported fever lasting up to three days, without any evident focus of infection, attending an outpatient clinic in the city of Rio de Janeiro, Brazil, between the years 2005 and 2008. Logistic regression analysis was used to identify symptoms, physical signs, and hematological features valid for dengue diagnosis. Receiver-operating characteristic (ROC) curve analyses were used to define the best cut-off and to compare the accuracy of generated models with the World Health Organization (WHO) criteria for probable dengue. RESULTS Based on serological tests and virus genome detection by polymerase chain reaction (PCR), 69 patients were classified as dengue and 73 as non-dengue. Among clinical features, conjunctival redness and history of rash were independent predictors of dengue infection. A model including clinical and laboratory features (conjunctival redness and leukocyte counts) achieved a sensitivity of 81% and specificity of 71% and showed greater accuracy than the WHO criteria for probable dengue. CONCLUSIONS We constructed a predictive model for early dengue diagnosis that was moderately accurate and performed better than the current WHO criteria for suspected dengue. Validation of this model in larger samples and in other sites should be attempted before it can be applied in endemic areas.
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Affiliation(s)
- Regina P Daumas
- Germano Sinval Faria Teaching Primary Care Center/National School of Public Health, Oswaldo Cruz Foundation – Fiocruz, Rio de Janeiro, 21041-210, Brazil
| | - Sonia RL Passos
- Laboratory of Clinical Epidemiology/Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation – Fiocruz, Rio de Janeiro, 21040-361, Brazil
| | - Raquel VC Oliveira
- Laboratory of Clinical Epidemiology/Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation – Fiocruz, Rio de Janeiro, 21040-361, Brazil
| | - Rita MR Nogueira
- Flavivirus Laboratory, Department of Virology, Instituto Oswaldo Cruz/FIOCRUZ, 21040-190, Rio de Janeiro, Brazil
| | - Ingebourg Georg
- Immunology Service/Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation – Fiocruz, Rio de Janeiro, 21040-361, Brazil
| | - Keyla BF Marzochi
- Laboratory of Acute Febrile Illnesses/Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation – Fiocruz, Rio de Janeiro, Brazil
| | - Patrícia Brasil
- Laboratory of Acute Febrile Illnesses/Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation – Fiocruz, Rio de Janeiro, Brazil
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Shepard DS, Undurraga EA, Lees RS, Halasa Y, Lum LCS, Ng CW. Use of multiple data sources to estimate the economic cost of dengue illness in Malaysia. Am J Trop Med Hyg 2012; 87:796-805. [PMID: 23033404 PMCID: PMC3516253 DOI: 10.4269/ajtmh.2012.12-0019] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 06/29/2012] [Indexed: 01/16/2023] Open
Abstract
Dengue represents a substantial burden in many tropical and sub-tropical regions of the world. We estimated the economic burden of dengue illness in Malaysia. Information about economic burden is needed for setting health policy priorities, but accurate estimation is difficult because of incomplete data. We overcame this limitation by merging multiple data sources to refine our estimates, including an extensive literature review, discussion with experts, review of data from health and surveillance systems, and implementation of a Delphi process. Because Malaysia has a passive surveillance system, the number of dengue cases is under-reported. Using an adjusted estimate of total dengue cases, we estimated an economic burden of dengue illness of US$56 million (Malaysian Ringgit MYR196 million) per year, which is approximately US$2.03 (Malaysian Ringgit 7.14) per capita. The overall economic burden of dengue would be even higher if we included costs associated with dengue prevention and control, dengue surveillance, and long-term sequelae of dengue.
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Affiliation(s)
- Donald S. Shepard
- Schneider Institutes for Health Policy, Heller School, Brandeis University, Waltham, Massachusetts; Centre for Research in Biotechnology for Agriculture, and Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Yip VCH, Sanjay S, Koh YT. Ophthalmic complications of dengue Fever: a systematic review. Ophthalmol Ther 2012; 1:2. [PMID: 25135582 PMCID: PMC4108139 DOI: 10.1007/s40123-012-0002-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Indexed: 11/30/2022] Open
Abstract
Introduction In recent years there has been a spurt of peer-reviewed publications on the ophthalmic complications of dengue fever. The authors aim to review the ocular manifestations, utility of relevant diagnostic tests, management, prognosis, and sequelae of dengue-related ocular complications. Methods A comprehensive literature search was conducted on Medline, PubMed, and Google Scholar databases. Only articles published or translated into the English language were considered, and key data from the full article of each paper was extracted and evaluated. Results The authors’ search yielded 29 articles. A total of 686 patients with a mean age of 33.4 years (range 14–73 years) were included. Blurring of vision was the most common presenting symptom followed by scotoma. Ocular findings were mostly seen in the posterior pole of the fundus, manifesting as retinal hemorrhages, macular edema, foveolitis, vasculitis, and optic neuropathy. Most patients with dengue-related ophthalmic complications recover spontaneously without any treatment. Patients with severe visual loss or bilateral involvement were treated with systemic steroids and occasionally immunoglobulins. Prognosis of dengue-related ophthalmic complications is favorable; almost all patients had normal or showed improvement in visual acuity and complete resolution of dengue ophthalmic complications was noted in almost all cases. Conclusion The pathological process of dengue ophthalmic complications is complex and clinical manifestations varied. Ophthalmic complications are usually seen in young adults who often present at the nadir of thrombocytopenia. Despite good recovery of vision and resolution of clinical signs in most patients, ophthalmologists and physicians should be aware and vigilant as isolated reports of cases of dengue ophthalmic complications with poor visual acuity refractory to treatment have been reported.
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Affiliation(s)
- Vivien Cherng-Hui Yip
- Ophthalmology Department, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
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Preechawat P, Poonyathalang A, Kurathong S, Leelawongs K, Pongthanapisit V. Non-ischaemic Central Retinal Vein Occlusion after Dengue Viral Infection. Neuroophthalmology 2012. [DOI: 10.3109/01658107.2011.643332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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LaBeaud AD, Bashir F, King CH. Measuring the burden of arboviral diseases: the spectrum of morbidity and mortality from four prevalent infections. Popul Health Metr 2011; 9:1. [PMID: 21219615 PMCID: PMC3024945 DOI: 10.1186/1478-7954-9-1] [Citation(s) in RCA: 131] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Accepted: 01/10/2011] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Globally, arthropod-borne virus infections are increasingly common causes of severe febrile disease that can progress to long-term physical or cognitive impairment or result in early death. Because of the large populations at risk, it has been suggested that these outcomes represent a substantial health deficit not captured by current global disease burden assessments. METHODS We reviewed newly available data on disease incidence and outcomes to critically evaluate the disease burden (as measured by disability-adjusted life years, or DALYs) caused by yellow fever virus (YFV), Japanese encephalitis virus (JEV), chikungunya virus (CHIKV), and Rift Valley fever virus (RVFV). We searched available literature and official reports on these viruses combined with the terms "outbreak(s)," "complication(s)," "disability," "quality of life," "DALY," and "QALY," focusing on reports since 2000. We screened 210 published studies, with 38 selected for inclusion. Data on average incidence, duration, age at onset, mortality, and severity of acute and chronic outcomes were used to create DALY estimates for 2005, using the approach of the current Global Burden of Disease framework. RESULTS Given the limitations of available data, nondiscounted, unweighted DALYs attributable to YFV, JEV, CHIKV, and RVFV were estimated to fall between 300,000 and 5,000,000 for 2005. YFV was the most prevalent infection of the four viruses evaluated, although a higher proportion of the world's population lives in countries at risk for CHIKV and JEV. Early mortality and long-term, related chronic conditions provided the largest DALY components for each disease. The better known, short-term viral febrile syndromes caused by these viruses contributed relatively lower proportions of the overall DALY scores. CONCLUSIONS Limitations in health systems in endemic areas undoubtedly lead to underestimation of arbovirus incidence and related complications. However, improving diagnostics and better understanding of the late secondary results of infection now give a first approximation of the current disease burden from these widespread serious infections. Arbovirus control and prevention remains a high priority, both because of the current disease burden and the significant threat of the re-emergence of these viruses among much larger groups of susceptible populations.
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Affiliation(s)
- A Desirée LaBeaud
- Center for Immunobiology and Vaccine Development, Children's Hospital Oakland Research Institute, Oakland, California, USA
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, USA
| | - Fatima Bashir
- Center for Immunobiology and Vaccine Development, Children's Hospital Oakland Research Institute, Oakland, California, USA
| | - Charles H King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, USA
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Gregory CJ, Santiago LM, Argüello DF, Hunsperger E, Tomashek KM. Clinical and laboratory features that differentiate dengue from other febrile illnesses in an endemic area--Puerto Rico, 2007-2008. Am J Trop Med Hyg 2010; 82:922-9. [PMID: 20439977 DOI: 10.4269/ajtmh.2010.09-0552] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Dengue infection can be challenging to diagnose early in the course of infection before severe manifestations develop, but early diagnosis can improve patient outcomes and promote timely public health interventions. We developed age-based predictive models generated from 2 years of data from an enhanced dengue surveillance system in Puerto Rico. These models were internally validated and were able to differentiate dengue infection from other acute febrile illnesses with moderate accuracy. The accuracy of the models was greater than either the current World Health Organization case definition for dengue fever or a proposed modification to this definition, while requiring the collection of fewer data. In young children, thrombocytopenia and the absence of cough were associated with dengue infection; for adults, rash, leucopenia, and the absence of sore throat were associated with dengue infection; in all age groups, retro-orbital pain was associated with dengue infection.
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Affiliation(s)
- Christopher J Gregory
- Epidemic Intelligence Service Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Seet RCS, Lee CYJ, Lim ECH, Quek AML, Yeo LLL, Huang SH, Halliwell B. Oxidative damage in dengue fever. Free Radic Biol Med 2009; 47:375-80. [PMID: 19427377 DOI: 10.1016/j.freeradbiomed.2009.04.035] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2009] [Revised: 04/02/2009] [Accepted: 04/29/2009] [Indexed: 12/11/2022]
Abstract
Oxidative stress may be important in the pathogenesis of dengue infection. Using accurate markers of oxidative damage, we assessed the extent of oxidative damage in dengue patients. The levels of hydroxyeicosatetraenoic acid products (HETEs), F(2)-isoprostanes (F(2)-IsoPs), and cholesterol oxidation products (COPs) were measured in 28 adult dengue patients and 28 age-matched study controls during the febrile, defervescent, and convalescent stages of infection. We compared the absolute and the percentage change in these markers in relation to key clinical parameters and inflammatory markers. The levels of total HETEs and total HETEs/arachidonate, total F(2)-IsoPs/arachidonate, and COPs/cholesterol were higher during the febrile compared to the convalescent level. Total HETEs correlated positively with admission systolic blood pressure (r=0.52, p<0.05), whereas an inverse relationship was found between 7beta-hydroxycholesterol and systolic and diastolic blood pressure (r=-0.61 and -0.59, respectively, p<0.01). The urinary F(2)-IsoP level was higher in urine during the febrile stage compared to the convalescent level. Despite lower total cholesterol levels during the febrile stage compared to convalescent levels, a higher percentage of cholesterol was found as COPs (7beta-, 24-, and 27-hydroxycholesterol). The levels of platelet-activating factor-acetylhydrolase activity, vascular cellular adhesion molecule-1, tumor necrosis factor-alpha, and high-sensitivity C-reactive protein were higher during the febrile stage compared to their convalescent levels (p<0.01). Markers of oxidative damage are altered during the various stages of dengue infection.
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Affiliation(s)
- Raymond C S Seet
- Department of Medicine, Yong Loo Lin School of Medicine, National University Hospital, Singapore 119074.
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Kumar V, Ghosh B, Raina UK, Goel N. Bilateral periorbital ecchymosis in a case with dengue fever. Indian J Ophthalmol 2009; 57:242-3. [PMID: 19384027 PMCID: PMC2683449 DOI: 10.4103/0301-4738.49407] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dengue maculopathy: visual electrophysiology and optical coherence tomography. Doc Ophthalmol 2009; 119:145-55. [DOI: 10.1007/s10633-009-9178-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2009] [Accepted: 06/08/2009] [Indexed: 10/20/2022]
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Rajapakse M, Kanagasabai R, Ang WT, Veeramani A, Schreiber MJ, Baker CJ. Ontology-centric integration and navigation of the dengue literature. J Biomed Inform 2008; 41:806-15. [DOI: 10.1016/j.jbi.2008.04.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2007] [Revised: 03/30/2008] [Accepted: 04/05/2008] [Indexed: 11/30/2022]
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