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3. Utility of the WHO dengue guidelines in pediatric immunological studies.

Author

Sánchez, Jorge L, Salgado, Doris M, Vega, Martha Rocío, Castro-Trujillo, Sebastián, and Narváez, Carlos F

Subjects
*DENGUE hemorrhagic fever, *DENGUE, *BIOMARKERS, *ACUTE diseases, *FLOW cytometry
Abstract

Dengue is a significant health problem due to the high burden of critical infections during outbreaks. In 1997, the World Health Organization (WHO) classified dengue as dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS). It was revised in 2009 (updated in 2015), and the new guidelines recommended classifying patients as dengue without warning signs (DNS), dengue with warning signs (DWS), and severe dengue (SD). Although the utility of the revised 2009 classification for clinical studies is accepted, for immunological studies it needs to be clarified. We determined the usefulness of the 2009 classification for pediatric studies that analyze the circulating interleukin (IL)-6 and IL-8, two inflammatory cytokines. Plasma levels of IL-6 and IL-8 were evaluated in the acute and convalescent phases by flow cytometry in children with dengue classified using the 1997 and 2009 WHO guidelines. The plasma levels of IL-6 and IL-8 were elevated during the acute and decreased during convalescence, and both cytokines served as a good marker of acute dengue illness compared to convalescence. There were no differences in the plasma level of the evaluated cytokines among children with different clinical severity with any classification, except for the IL-8, which was higher in DWS than DNS. Based on the levels of IL-8, the 2009 classification identified DWS plus SD (hospital-treated children) compared to the DNS group [area under the curve (AUC): 0.7, p  = 0.028]. These results support the utility of the revised 2009 (updated in 2015) classification in studies of immune markers in pediatric dengue. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Rapid antigen tests for dengue virus serotypes and Zika virus in patient serum

Author

Bosch, Irene, de Puig, Helena, Hiley, Megan, Carré-Camps, Marc, Perdomo-Celis, Federico, Narváez, Carlos F., Salgado, Doris M., Senthoor, Dewahar, O’Grady, Madeline, Phillips, Elizabeth, Durbin, Ann, Fandos, Diana, Miyazaki, Hikaru, Yen, Chun-Wan, Gélvez-Ramírez, Margarita, Warke, Rajas V., Ribeiro, Lucas S., Teixeira, Mauro M., Almeida, Roque P., Muñóz-Medina, José E., Ludert, Juan E., Nogueira, Mauricio L., Colombo, Tatiana E., Terzian, Ana C. B., Bozza, Patricia T., Calheiros, Andrea S., Vieira, Yasmine R., Barbosa-Lima, Giselle, Vizzoni, Alexandre, Cerbino-Neto, José, Bozza, Fernando A., Souza, Thiago M. L., Trugilho, Monique R. O., de Filippis, Ana M. B., de Sequeira, Patricia C., Marques, Ernesto T. A., Magalhaes, Tereza, Díaz, Francisco J., Restrepo, Berta N., Marín, Katerine, Mattar, Salim, Olson, Daniel, Asturias, Edwin J., Lucera, Mark, Singla, Mohit, Medigeshi, Guruprasad R., de Bosch, Norma, Tam, Justina, Gómez-Márquez, Jose, Clavet, Charles, Villar, Luis, Hamad-Schifferli, Kimberly, and Gehrke, Lee

Published
2017
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12. Evaluación de las variantes en los genes IL6R, TLR3 y DC-SIGN asociadas con dengue en una muestra de población colombiana

Author

Avendaño-Tamayo, Efrén, Rúa, Alex, Parra-Marín, María Victoria, Rojas, Winston, Campo, Omer, Chacón-Duque, Juan, Agudelo-Flórez, Piedad, Narváez, Carlos F., Salgado, Doris M., Restrepo, Bertha Nelly, and Bedoya, Gabriel

Subjects
polymorphism, genetic, toll-like receptor 3, Colombia, Dengue/genetics
Abstract

Introduction: Host genetics is recognized as an influential factor for the development of dengue disease. Objective: This study evaluated the association of dengue with the polymorphisms rs8192284 for gene IL6R, rs3775290 for TLR3, and rs7248637 for DC-SIGN. Materials and methods: Of the 292 surveyed subjects, 191 were confirmed for dengue fever and the remaining 101 were included as controls. The genotypes were resolved using polymerase chain reaction and restriction fragment length polymorphism (PCR- RFLP). In an attempt to determine the risk (Odds Ratio) of suffering dengue fever, data were analyzed using chi-square for alleles and logistic regression for both genotypes and allelic combinations. Confidence intervals were set to 95% for all tests regardless of the adjustment by either self-identification or ancestry. Results: For Afro-Colombians, the allele rs8192284 C offered protection against dengue [OR=0.425,(0.204-0.887), p=0.020]. The alleles rs7248637 A and rs3775290 A posed, respectively, an increased risk of dengue for Afro-Colombians [OR=2.389, (1.170-4.879), p=0.015] and Mestizos [OR=2.329, (1.283-4.226), p=0.005]. The reproducibility for rs8192284 C/C [OR=2.45, (1.05-5.76), p=0.013] remained after adjustment by Amerindian ancestry [OR=2.52, (1.04-6.09), p=0.013]. The reproducibility for rs3775290 A/A [OR=2.48, (1.09-5.65), p=0.033] remained after adjustment by European [OR=2.34, (1.02-5.35), p=0.048], Amerindian [OR=2.49, (1.09-5.66), p=0.035], and African ancestry [OR=2.37, (1.04-5.41), p=0.046]. Finally, the association of dengue fever with the allelic combination CAG [OR=2.07, (1.06-4.05), p=0.033] remained after adjustment by Amerindian ancestry [OR=2.16, (1.09-4.28), p=0.028]. Conclusions: Polymorphisms rs8192284 for IL6R, rs3775290 for TLR3, and rs7248637 for DC-SIGN were associated with the susceptibility to suffer dengue fever in the sampled Colombian population. Resumen Introducción. La genética del huésped se reconoce como un factor que influye en el desarrollo del dengue. Objetivo. Este estudio evaluó la asociación del dengue con los polimorfismos rs8192284 del gen IL6R, rs3775290 del TLR3 y rs7248637 del DC-SIGN. Materiales y métodos. De los 292 sujetos encuestados, en 191 se confirmó la presencia de fiebre por dengue y los restantes 101 se incluyeron como controles. Los genotipos se resolvieron mediante reacción en cadena de la polimerasa y polimorfismos en la longitud de los fragmentos de restricción (PCR-RFLP). En un intento por determinar el riesgo de sufrir dengue, los datos se analizaron mediante la prueba de ji al cuadrado para los alelos y la regresión logística para los genotipos y las combinaciones alélicas. Los intervalos de confianza se calcularon a 95 % para todas las pruebas independientemente ajustadas por autoidentificación o componente genético ancestral. Resultados. En los afrocolombianos, el alelo C rs8192284 ofreció protección contra el dengue (OR=0,425; 0,204-0,887, p=0,020). Los alelos A rs7248637 y Ars3775290 plantearon un mayor riesgo de dengue para los afrocolombianos (OR=2,389; 1,170- 4,879; p=0,015) y los mestizos (OR=2,329; 1,283-4,226: p=0,005), respectivamente. La reproducibilidad para rs8192284 C/C (OR=2,45; 1,05-5,76; p=0,013) permaneció después del ajuste por el componente genético ancestral amerindio (OR=2,52; 1,04- 6,09; p=0,013). La reproducibilidad del rs3775290 A/A (OR=2,48; 1,09-5,65; p=0,033) permaneció después del ajuste por el componente europeo (OR=2,34; 1,02-5,35; p=0,048), el amerindio (OR=2,49; 1,09- 5,66; p=0,035), y el africano (OR=2,37; 1,04- 5,41; p=0,046). Por último, la asociación del dengue con la combinación alélica CAG (OR=2,07; 1,06-4,05; p=0,033) permaneció después del ajuste por el componente genético amerindio (OR=2,16; 1,09-4,28;p=0,028). Conclusión. Los polimorfismos rs8192284 en IL6R, rs3775290 en TLR3 y rs7248637 en DC-SIGN, se asociaron con la propensión a sufrir dengue en una muestra de población colombiana.

Published
2019

13. Evaluation of variants in IL6R, TLR3, and DC-SIGN genes associated with dengue in sampled Colombian population

Author

Avendaño-Tamayo, Efren, Rúa, Alex, Parra-Marín, María Victoria, Rojas, Winston, Campo, Omer, Chacón-Duque, Juan, Agudelo-Flórez, Piedad, Narváez, Carlos F., Salgado, Doris M., Restrepo, Bertha Nelly, Bedoya, Gabriel, Avendaño-Tamayo, Efren, Rúa, Alex, Parra-Marín, María Victoria, Rojas, Winston, Campo, Omer, Chacón-Duque, Juan, Agudelo-Flórez, Piedad, Narváez, Carlos F., Salgado, Doris M., Restrepo, Bertha Nelly, and Bedoya, Gabriel

Abstract

Introduction: Host genetics is recognized as an influential factor for the development of dengue disease.Objective: This study evaluated the association of dengue with the polymorphisms rs8192284 for gene IL6R, rs3775290 for TLR3, and rs7248637 for DC-SIGN.Materials and methods: Of the 292 surveyed subjects, 191 were confirmed for dengue fever and the remaining 101 were included as controls. The genotypes were resolved using polymerase chain reaction and restriction fragment length polymorphism (PCRRFLP). In an attempt to determine the risk (Odds Ratio) of suffering dengue fever, data were analyzed using chi-square for alleles and logistic regression for both genotypes and allelic combinations. Confidence intervals were set to 95% for all tests regardless of the adjustment by either self-identification or ancestry.Results: For Afro-Colombians, the allele rs8192284 C offered protection against dengue [OR=0.425,(0.204-0.887), p=0.020]. The alleles rs7248637 A and rs3775290 A posed, respectively, an increased risk of dengue for Afro-Colombians [OR=2.389, (1.170-4.879), p=0.015] and Mestizos [OR=2.329, (1.283-4.226), p=0.005]. The reproducibility for rs8192284 C/C [OR=2.45, (1.05-5.76), p=0.013] remained after adjustment by Amerindian ancestry [OR=2.52, (1.04-6.09), p=0.013]. The reproducibility for rs3775290 A/A [OR=2.48, (1.09-5.65), p=0.033] remained after adjustment by European [OR=2.34, (1.02-5.35), p=0.048], Amerindian [OR=2.49, (1.09-5.66), p=0.035], and African ancestry [OR=2.37, (1.04-5.41), p=0.046]. Finally, the association of dengue fever with the allelic combination CAG [OR=2.07, (1.06-4.05), p=0.033] remained after adjustment by Amerindian ancestry [OR=2.16, (1.09-4.28), p=0.028].Conclusions: Polymorphisms rs8192284 for IL6R, rs3775290 for TLR3, and rs7248637 for DC-SIGN were associated with the susceptibility to suffer dengue fever in the sampled Colombian population., Introducción. La genética del huésped se reconoce como un factor que influye en el desarrollo del dengue.Objetivo. Este estudio evaluó la asociación del dengue con los polimorfismos rs8192284 del gen IL6R, rs3775290 del TLR3 y rs7248637 del DC-SIGN.Materiales y métodos. De los 292 sujetos encuestados, en 191 se confirmó la presencia de fiebre por dengue y los restantes 101 se incluyeron como controles. Los genotipos se resolvieron mediante reacción en cadena de la polimerasa y polimorfismos en la longitud de los fragmentos de restricción (PCR-RFLP). En un intento por determinar el riesgo de sufrir dengue, los datos se analizaron mediante la prueba de ji al cuadrado para los alelos y la regresión logística para los genotipos y las combinaciones alélicas. Los intervalos de confianza se calcularon a 95 % para todas las pruebas independientemente ajustadas por autoidentificación o componente genético ancestral.Resultados. En los afrocolombianos, el alelo C rs8192284 ofreció protección contra el dengue (OR=0,425; 0,204-0,887, p=0,020). Los alelos A rs7248637 y A rs3775290 plantearon un mayor riesgo de dengue para los afrocolombianos (OR=2,389; 1,170-4,879; p=0,015) y los mestizos (OR=2,329; 1,283-4,226: p=0,005), respectivamente. La reproducibilidad para rs8192284 C/C (OR=2,45; 1,05-5,76; p=0,013) permaneció después del ajuste por el componente genético ancestral amerindio (OR=2,52; 1,04-6,09; p=0,013). La reproducibilidad del rs3775290 A/A (OR=2,48; 1,09-5,65; p=0,033) permaneció después del ajuste por el componente europeo (OR=2,34; 1,02-5,35; p=0,048), el amerindio (OR=2,49; 1,09- 5,66; p=0,035), y el africano (OR=2,37; 1,04-5,41; p=0,046). Por último, la asociación del dengue con la combinación alélica CAG (OR=2,07; 1,06-4,05; p=0,033) permaneció después del ajuste por el componente genético amerindio (OR=2,16; 1,09-4,28; p=0,028).Conclusión. Los polimorfismos rs8192284 en IL6R, rs3775290 en TLR3 y rs7248637 en DC-SIGN, se asociaron con la propensión a sufrir dengue

Published
2019

19. Evaluation of variants in IL6R, TLR3, and DC-SIGN genes associated with dengue in a sampled Colombian population.

Author

Avendaño-Tamayo, Efrén, Rúa, Alex, Parra-Marín, María Victoria, Rojas, Winston, Campo, Omer, Chacón-Duque, Juan, Agudelo-Flórez, Piedad, Narváez, Carlos F., Salgado, Doris M., Restrepo, Bertha Nelly, and Bedoya, Gabriel

Subjects
DENGUE hemorrhagic fever, DENGUE, RESTRICTION fragment length polymorphisms, POLYMERASE chain reaction
Abstract

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2019
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24. Compromiso hepático por Dengue en niños del Huila, Colombia

Author

Acosta, Héctor F, Bayona, Miguel A, Zabaleta, Tatiana E, Villar, Luis A, Narváez, Carlos F, Rodríguez, Jairo A, and Salgado, Doris M

Subjects
disfunción hepática, dengue con signos de alarma (DSA), hepatic dysfunction, Virus dengue (DENV), leptospirosis, Dengue virus (DENV), dengue with warning signs (DWS), hepatitis, dengue grave (DG), severe dengue (SD)
Abstract

Objetivo Determinar la frecuencia y severidad del compromiso hepático en niños con Dengue. Métodos Estudio descriptivo que incluyó a 108 niños menores de 13 años con diagnóstico de infección por virus de Dengue, confirmada por detección plasmática de NS1 e IgM dengue-específica, que consultaron al Hospital Universitario de Neiva, en el período de junio de 2009 a mayo de 2010.El grado de daño hepático fue evaluado por criterios clínicos y bioquímicos que incluyeron transaminasas y albúmina. El diagnóstico de infección con Leptospira o Hepatitis A fue realizado por detección de IgM plasmática específica medida en fase aguda y convaleciente. Resultados De los casos incluidos, 98 y 10 casos fueron clasificados como dengue con signos de alarma y Dengue grave, respectivamente. Dos de cada tres pacientes con Dengue presentaron signos de alarma y todos los pacientes con Dengue grave presentaron algún grado de compromiso hapático evidenciado clínica y bioquímicamente. Independientemente de la clasificación clínica, la hepatomegalia fue el signo clínico cardinal del compromiso hepático y se presentó en el 85 % del total de niños incluidos. De resaltar, 5 de los pacientes presentaron probable coinfección de dengue y leptospira, siendo la primera descripción en Colombia. En ninguno de los casos analizados se presentó enfermedad aguda por Hepatitis A. Conclusión El compromiso hepático es muy frecuente en la infección por virus Dengue. Enfermedades como la leptospirosis deben ser tenidas en cuenta no sólo en el diagnóstico diferencial del paciente pediátrico febril con compromiso hepático, sino como causa de coinfección en el niño con Dengue en el sur de Colombia. Objective Dengue is the most important arthropod-borne viral disease in the world; it can be life-threatening because of liver involvement. Aim Determining liver involvement frequency and severity in dengue-infected children. Methods This was a descriptive case series study which involved studying 108 dengue-infected children aged less than 13 years old whose infection had been confirmed by the detection of dengue-specific IgM and NS1 in plasma. Clinical and biochemical parameters were used for evaluating liver involvement, including transaminases and albumin. Hepatitis A and leptospira infection were also evaluated by using ELISA to detect pathogen-specific IgM in plasma during acute and convalescence phases. The study was carried out at a teaching hospital in Neiva from June 2009 to May 2010. Results Ninety-eight of the aforementioned cases were clinically classified as dengue with warning signs (DWS) and 10 as severe dengue (SD). Two out of three DWS patients and all SD patients had some degree of liver involvement, shown clinically and biochemically. Regardless of the clinical classification, hepatomegaly was the main clinical sign of liver involvement and was present in 85% of all the children in the study. It is worth noting that 5 patients had probable dengue and leptospirosis co-infection, this being the first instance of this in Colombia. None of the cases analyzed here had acute hepatitis A. Conclusions Liver compromise should be considered in confirmed cases of dengue as shown in this series of children. Leptospirosis must be considered as differential diagnosis and also as causing co-infection in a febrile child.

Published
2012

25. Miocarditis en Niños con Fiebre por Dengue Hemorrágico en un Hospital Universitario de Colombia

Author

Salgado, Doris M, Panqueba, Cesar A, Castro, Dolly, R.Vega, Martha, and Rodríguez, Jairo A

Subjects
Dengue, miocarditis, dengue hemorrhagic fever, myocarditis, fiebre dengue hemorrágica
Abstract

Objetivo Determinar la frecuencia de miocarditis en niños con fiebre por Dengue hemorrágico-FDH, en el Huila, Colombia. Materiales y Métodos Se realizó un estudio descriptivo de observación prospectiva, entre Marzo del 2005 y Octubre de 2006. Se observaron 102 pacientes con diagnóstico de FDH, basado en los criterios de la OMS, para identificar la frecuencia de miocarditis. Resultados Un 10,7 % de los niños presentaron miocarditis. Solo un caso con miocarditis fue clasificado como dengue II; los otros diez casos fueron dengue III y IV. La diferencia en la presentación de miocarditis en los estadíos más severos de dengue fue estadísticamente significativa, con un p=0.0004. Diez de los pacientes tuvieron miocarditis que respondió al soporte inotrópico temprano. En el electrocardiograma (EKG), dos pacientes presentaron taquiarritmias, uno tipo supraventricular y otro ventricular, el resto mostró bradicardia sinusal con trastornos de repolarización y bajos voltajes. El ecocardiograma se realizó en 50 % de los niños, encontrándose derrame pericárdico grado I-II en dos pacientes y uno con la fracción de eyección muy disminuida. La estancia promedio fue de 7 días. Un paciente presentó desenlace fatal. Conclusión La presentación de miocarditis alerta sobre la presencia de disfunción miocárdica como una patología a considerarse en pacientes con FDH. Objective To determining myocarditis frequency in children suffering from DHF in the Huila region of Colombia. Methods This was a descriptive and prospective study which was carried out between March 2005 and October 2005 involving 102 patients suffering from DHF, based on WHO criteria. These children were followed-up to identify signs of myocarditis. Results 10.7 % of the children had signs of myocarditis; one of them was classified as having dengue II and the other ten were classified as suffering form dengue III and IV. This difference was statistically significant (p=0.0004). 10 patients had fulminant myocarditis and required early inotropic support. Two patients had tachyarrythmias in the EKG (one SV and one ventricular); the others had sinusal bradichardia and low voltages. Echocardiograms were perfomed on 50 % of the children, revealing pericardial leakage grade I and II in two patients, one with very diminished EF and AF. Average hospital stay was 7 days. 10 had satisfactory outcome whereas one died. Conclusion This series of cases in children reinforces the association between myocarditis and dengue viral infection.

Published
2009

26. Caracterización Clínica y Epidemiológica de Dengue Hemorrágico en Neiva, Colombia, 2004

Author

Salgado, Doris M, Rodríguez, Jairo A., Garzón, Marisol, Cifuentes, Gerson, Ibarra, Milton, Vega, Martha R., and Castro, Dolly

Subjects
miocarditis, dengue hemorrhagic fever, human viral hepatitis, Fiebre dengue, dengue hemorrágica, hepatitis viral humana, myocarditis, Dengue fever, dengue
Abstract

Objetivo Neiva es considerada endémica para fiebre dengue y fiebre dengue hemorrágico en Colombia. Durante el 2004 se presentó un brote epidémico, siendo necesario caracterizar el comportamiento epidemiológico y clínico durante esta epidemia. Materiales y Métodos Estudio retrospectivo descriptivo de niños menores de 13 años que ingresaron al Hospital Universitario en este periodo, con criterios de Fiebre dengue y Fiebre dengue hemorrágico según la OMS. Se registraron los datos demográficos, clínicos y paraclínicos de ingreso. El análisis fue descriptivo y bivariado exploratorio utilizando la prueba de chi². Resultados De 105 niños el 87,6 % ingresó con diagnóstico de fiebre dengue hemorrágico y el 12,4 % con fiebre dengue. Un 67 % correspondió a menores de 5 años, con mayor frecuencia y severidad en niñas. El 83 % ingresó en los primeros seis días de enfermedad. Hubo datos de choque en el 20 % de los pacientes, de estos el 76 % presentó complicaciones (chi² 29.53, gl 6, p=0.0000). Entre los datos paraclínicos, las aminotransferasas se encontraron 3 a 5 veces el valor normal y hubo correlación entre recuento plaquetario inferior a 20 000 por mm³ y choque al ingreso (chi² 20,65, gl 4, p= 0.0004). La evolución fue favorable; sin embargo, hubo complicaciones en el 32 % de los casos (13 % miocarditis, 19 % hepatitis o encefalitis y 2 % sepsis). Conclusión Las características epidemiológicas y clínicas observadas en esta cohorte de pacientes mostraron una variación en género, edad y órgano blanco, con una incidencia alta de compromiso miocárdico. Objective Neiva (a southern Colombia city) is endemic for dengue fever and dengue haemorrhagic fever. Neiva has suffered outbreaks of dengue, that in 2004 being the latest one. This study was designed to characterise epidemiological and clinical data from that outbreak of dengue. Material and Methods This was a descriptive, retrospective study of children aged less than 13 years who were admitted to the University Hospital and fulfilled the WHO's clinical and laboratory criteria for dengue or dengue haemorrhagic fever. Demographic, clinical and paraclinical data were recorded and analysed using Chi square (chi²) bivariate tabular test. Results 105 children were diagnosed as suffering from either dengue haemorrhagic fever (87.6%) or dengue fever (12.4%); 67% of them were aged less than 5 years. Girls were more frequently affected by severe clinical manifestations. 83% of the children were admitted during the first six days of the disease; dengue shock syndrome was diagnosed in 20% and 76% presented clinical complications (chi² 29.53, gl 6, p=0.0000). Aminotransferases were 3 to 5 times above normal levels. There was a statistical correlation between low platelet count (less than 20 000 per mm³) and shock during admission (chi² 20.65, gl 4, p=0.0004). Complications arose during clinical evolution in 32% of the cases (13% myocarditis, 19% hepatitis or encephalitis and 2% sepsis). Conclusion The clinical and epidemiological characteristics observed in this cohort evidenced differences in age, gender and organs affected compared to data described in the literature; there was a high incidence of myocarditis.

Published
2007

30. Compromiso hepático por Dengue en niños del Huila, Colombia.

Author

Acosta, Héctor F., Bayona, Miguel A., Zabaleta, Tatiana E., Villar, Luis A., Narváez, Carlos F., Rodríguez, Jairo A., and Salgado, Doris M.

Abstract

Copyright of Revista de Salud Pública is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2012

31. High plasma levels of soluble ST2 but not its ligand IL-33 is associated with severe forms of pediatric dengue

Author

Pontificia Universidad Javeriana. Facultad de Medicina. Instituto de Genética Humana, Rodríguez Camacho, Luz Stella, Guerrero, Christian D., Arrieta, Andres F., Ramirez, Nestor D., Vega, Rocio, Bosch, Irene, Rodriguez, Jairo A., Narvaez, Carlos F., Salgado, Doris M., Pontificia Universidad Javeriana. Facultad de Medicina. Instituto de Genética Humana, Rodríguez Camacho, Luz Stella, Guerrero, Christian D., Arrieta, Andres F., Ramirez, Nestor D., Vega, Rocio, Bosch, Irene, Rodriguez, Jairo A., Narvaez, Carlos F., and Salgado, Doris M.

32. Total and envelope protein-specific antibody-secreting cell response in pediatric dengue is highly modulated by age and subsequent infections

Author

Pontificia Universidad Javeriana. Facultad de Medicina. Instituto de Genética Humana, Toro, Jessica F., Salgado, Doris M., Vega, Rocío, Rodríguez, Jairo A., Rodríguez, Luz-Stella, Ángel Uribe, Juanita, Franco Cortés, Manuel Antonio, Greenberg, Harry B., Narváez, Carlos, Pontificia Universidad Javeriana. Facultad de Medicina. Instituto de Genética Humana, Toro, Jessica F., Salgado, Doris M., Vega, Rocío, Rodríguez, Jairo A., Rodríguez, Luz-Stella, Ángel Uribe, Juanita, Franco Cortés, Manuel Antonio, Greenberg, Harry B., and Narváez, Carlos

34. [Dengue-related hepatic compromise in children from the Huila department of Colombia].

Author

Acosta HF, Bayona MA, Zabaleta TE, Villar LA, Narváez CF, Rodríguez JA, and Salgado DM

Subjects
Child, Preschool, Colombia epidemiology, Female, Humans, Male, Severity of Illness Index, Dengue complications, Liver Diseases epidemiology, Liver Diseases etiology
Abstract

Objective: Dengue is the most important arthropod-borne viral disease in the world; it can be life-threatening because of liver involvement. Aim Determining liver involvement frequency and severity in dengue-infected children., Methods: This was a descriptive case series study which involved studying 108 dengue-infected children aged less than 13 years old whose infection had been confirmed by the detection of dengue-specific IgM and NS1 in plasma. Clinical and biochemical parameters were used for evaluating liver involvement, including transaminases and albumin. Hepatitis A and leptospira infection were also evaluated by using ELISA to detect pathogen-specific IgM in plasma during acute and convalescence phases. The study was carried out at a teaching hospital in Neiva from June 2009 to May 2010., Results: Ninety-eight of the aforementioned cases were clinically classified as dengue with warning signs (DWS) and 10 as severe dengue (SD). Two out of three DWS patients and all SD patients had some degree of liver involvement, shown clinically and biochemically. Regardless of the clinical classification, hepatomegaly was the main clinical sign of liver involvement and was present in 85% of all the children in the study. It is worth noting that 5 patients had probable dengue and leptospirosis co-infection, this being the first instance of this in Colombia. None of the cases analyzed here had acute hepatitis A., Conclusions: Liver compromise should be considered in confirmed cases of dengue as shown in this series of children. Leptospirosis must be considered as differential diagnosis and also as causing co-infection in a febrile child.

Published
2012

35. Levels of soluble ST2 in serum associated with severity of dengue due to tumour necrosis factor alpha stimulation.

Author

Houghton-Triviño N, Salgado DM, Rodríguez JA, Bosch I, and Castellanos JE

Subjects
Adolescent, Adult, Biomarkers, Cell Line, Cells, Cultured, Child, Child, Preschool, Dengue diagnosis, Endothelial Cells immunology, Enzyme-Linked Immunosorbent Assay methods, Female, Gene Expression Profiling, Humans, Interleukin-1 Receptor-Like 1 Protein, Leukocytes, Mononuclear immunology, Male, Middle Aged, Reverse Transcriptase Polymerase Chain Reaction methods, Serum chemistry, Young Adult, Dengue immunology, Dengue pathology, Receptors, Cell Surface blood, Tumor Necrosis Factor-alpha immunology
Abstract

The interleukin-1 receptor-like-1 protein (IL1RL1), also known as ST2, has been shown previously to regulate T-cell function and is produced by T cells and endothelial cells. It was reported recently to be elevated in mild dengue patients during acute disease. The ST2 gene encodes several splice products: L (long), V (short) and s (soluble). A cohort of 38 patients with dengue haemorrhagic fever (DHF) and mild dengue fever (DF) were evaluated using a secreted soluble ST2 (sST2) ELISA. The RNA expression of ST2 was evaluated by real-time quantitative RT-PCR using patients' peripheral blood mononuclear cells (PBMCs) and in vitro using human umbilical vein endothelial cells (HUVECs) exposed to sera from dengue patients. DHF patients had higher levels of serum sST2, tumour necrosis factor alpha (TNF-alpha), interleukin (IL)-8 and IL-10 compared with DF patients and normal healthy control individuals. However, viraemia was indistinguishable between mild and severe cases. No changes in ST2 mRNA expression were found in PBMCs from these two groups of dengue patients. In vitro, sST2 was elevated in HUVECs treated with patient sera. Neutralization of TNF-alpha in patient sera by pre-treatment with a TNF-alpha antibody inhibited the upregulation of sST2 expression in HUVECs. These results implicate serum TNF-alpha in the modulation of expression of sST2 in an in vitro system, and indicate that sST2 could be associated with the severity of disease. Further studies to determine whether sST2 levels are predictive of the severe form of the disease and the role of sST2 in immune regulation are warranted.

Published
2010
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36. [Myocarditis in children affected by dengue hemorrhagic fever in a teaching hospital in Colombia].

Author

Salgado DM, Panqueba CA, Castro D, R Vega M, and Rodríguez JA

Subjects
Adolescent, Catchment Area, Health, Child, Colombia epidemiology, Female, Humans, Male, Prevalence, Prospective Studies, Hospitals, Teaching statistics & numerical data, Myocarditis epidemiology, Severe Dengue epidemiology
Abstract

Objective: To determining myocarditis frequency in children suffering from DHF in the Huila region of Colombia., Methods: This was a descriptive and prospective study which was carried out between March 2005 and October 2005 involving 102 patients suffering from DHF, based on WHO criteria. These children were followed-up to identify signs of myocarditis., Results: 10.7 % of the children had signs of myocarditis; one of them was classified as having dengue II and the other ten were classified as suffering form dengue III and IV. This difference was statistically significant (p=0.0004). 10 patients had fulminant myocarditis and required early inotropic support. Two patients had tachyarrythmias in the EKG (one SV and one ventricular); the others had sinusal bradichardia and low voltages. Echocardiograms were perfomed on 50 % of the children, revealing pericardial leakage grade I and II in two patients, one with very diminished EF and AF. Average hospital stay was 7 days. 10 had satisfactory outcome whereas one died., Conclusion: This series of cases in children reinforces the association between myocarditis and dengue viral infection.

Published
2009
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37. [Clinical and epidemiological characterisation of dengue haemorrhagic fever in Neiva, Colombia, 2004].

Author

Salgado DM, Rodríguez JA, Garzón M, Cifuentes G, Ibarra M, Vega MR, and Castro D

Subjects
Child, Child, Preschool, Colombia epidemiology, Female, Humans, Infant, Male, Retrospective Studies, Severe Dengue diagnosis, Severe Dengue epidemiology
Abstract

Objective: Neiva (a southern Colombia city) is endemic for dengue fever and dengue haemorrhagic fever. Neiva has suffered outbreaks of dengue, that in 2004 being the latest one. This study was designed to characterise epidemiological and clinical data from that outbreak of dengue., Material and Methods: This was a descriptive, retrospective study of children aged less than 13 years who were admitted to the University Hospital and fulfilled the WHO's clinical and laboratory criteria for dengue or dengue haemorrhagic fever. Demographic, clinical and paraclinical data were recorded and analysed using Chi square (chi(2)) bivariate tabular test., Results: 105 children were diagnosed as suffering from either dengue haemorrhagic fever (87.6%) or dengue fever (12.4%); 67% of them were aged less than 5 years. Girls were more frequently affected by severe clinical manifestations. 83% of the children were admitted during the first six days of the disease; dengue shock syndrome was diagnosed in 20% and 76% presented clinical complications (chi(2) 29.53, gl 6, p=0.0000). Aminotransferases were 3 to 5 times above normal levels. There was a statistical correlation between low platelet count (less than 20 000 per mm(3)) and shock during admission (chi(2) 20.65, gl 4, p=0.0004). Complications arose during clinical evolution in 32% of the cases (13% myocarditis, 19% hepatitis or encephalitis and 2% sepsis)., Conclusion: The clinical and epidemiological characteristics observed in this cohort evidenced differences in age, gender and organs affected compared to data described in the literature; there was a high incidence of myocarditis.

Published
2007
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