Asian Journal of Pediatric Research

Background: Dengue is a viral disease transmitted by mosquito bites with arising global incidence, more commonly afflicting children in endemic countries such as Bangladesh. Among the severe forms, such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS), there are hematological and biochemical complications. This study aims to evaluate the clinical, hematological and biochemical predictor of severity in pediatric dengue syndromes with the intention of improved clinical management. 

Methods: A cross sectional analytical study conducted at the Department of Pediatrics, Dhaka Medical College Hospital from April 2019 to March 2020. A total of 350 hospitalized children aged 1 month to 12 years with confirmed dengue positive were included in this study. Descriptive statistics were performed on clinical symptoms, hematological parameters and biochemical markers in order to test corresponding standard significance tests. 

Results: The most common symptoms were high grade fever (93.14%); vomiting (78.86%); abdominal pain (43.14%). 14.85% of DSS cases had severe thrombocytopenia (<20,000 cells/mm³). 13.86 % of DSS cases had elevated hematocrit (>45 %). In severe cases there were biochemical derangements including high SGPT (59.76% in DHF) and prolonged PT (>16 seconds). In DSS 35.15% were hypoproalbuminemic (< 3.0 gm/dl). Expanded dengue syndrome was characterized by hypocalcemia (62.5%) and elevated serum creatinine (25%). 

Conclusion: The clinical and laboratory markers highlighted here for early detection of severe dengue in children will help in early intervention to reduce morbidity and mortality.