Predictive value of CRP as a marker of severe dengue
Journal Title: Medpulse International Journal of Pediatrics - Year 2018, Vol 8, Issue 2
Abstract
Context: The cornerstone of management of patients with dengue and prevention of dengue-related mortality is early recognition of severe cases and timely management.C-reactive protein (CRP) is an important marker of inflammation claimed to be useful as a single measurement parameter of severity of dengue infection.Studies in paediatric population using CRP as the sole criteria have been limited. This study attempts to assess the usefulness of CRP to identify patients who are at risk for developing severe dengue illness in places where medical resources are sparse.Aims: To determine whether CRP can be used as an early predictor of severe dengue illnessStatistical analysis: For statistical significance of the measured CRP values, Mann Whitney U test were used.To determine the cut-off value of CRP in different dengue classification categories, ROC (Receiver operator characteristics) curve analysis was used and sensitivity and specificity of cut- off CRP was determined.Results:Of the 154 cases of serology positive dengue cases, 74.6% (n115) were cases ofnon-severe dengue, 18.8% (n29) were cases of severe shock who had presented in the early phase, and later progressed to dengue shock syndrome, 3.2%(n5) were cases of dengue haemorrhagic shock and 3.2% (n5) were cases of expanded dengue syndrome.The median value of CRP measured early in the disease process was 7.5mg/l of the severe dengue group, (17 mg/l of the expanded dengue group); higher than CRP value of 1.9mg/l of the non-severe dengue group.The P value of this median CRP between the severe dengue group and the Non severe dengue group was determined to be significant (Table -4).ROC analysis done to determine the cut off value of CRP, to differentiate severe dengue and non-severe dengue was 6 mg/dl with 100 % sensitivity and 80 % specificity with area under curve (AUC) of 0.95 which shows that severe dengue categories have a higher CRP value compared to the non-severe dengue .
Authors and Affiliations
Nancy Jeniffer V, Swathi NK
Keywords
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- EP ID EP445031
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