Serum ferritin levels as an early prognostic marker in dengue fever

Dengue virus infection is showing upsurge with rapid urbanization and climate change in India. The spectrum of disease varies from mild illness to severe disease such as dengue hemorrhagic syndrome, dengue shock, multi-organ failure, and death therefore prompt recognition of severe form is crucial to improve the survival in severe dengue. Currently there are no tests available to predict the course of the illness therefore it is imperative to develop an early reliable and feasible biomarker to predict the severity of dengue illness which can aid in vigorous monitoring and early intervention. In this study we tried to establish a correlation between serum ferritin and severity of dengue illness and analyzed whether serum ferritin can be used to predict the severity at an earlier stage.
Methods: This was a Cross sectional study conducted at tertiary care hospital. 350 patients above 18 years with fever of duration less than 2 weeks with thrombocytopenia were enrolled. Serum ferritin levels were measured and results were analyzed.
Results: Out of 350 patients Dengue was diagnosed in 210 patients. Mean Ferritn levels were highest in dengue patients (2898.18±2097.72 μg/l) and Severe dengue patients had significantly higher median ferritin levels (3985 μg/l) compared to non-severe dengue group with median 1936 μg/l (p value <0.001).
Conclusion: Serum ferritin can serve as a surrogate marker of dengue fever. Serum ferritin is an inexpensive and easily accessible biomarker that can be used as a prognostic marker to predict severity of disease.