Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020639 (hypoproteinemia)
 1,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A major outbreak of dengue hemorrhagic fever (DHF) affected more than 10,000 people in Delhi and neighboring areas in 1996. The outbreak started in September, peaked in October to November and lasted till early December. The clinical and laboratory data of 515 adult patients admitted to Lok Nayak Hospital, New Delhi were reviewed. Fever (100%), myalgias and malaise (96%), abdominal pain (10.2%) and vomiting (8.7%) were the prominent presenting features. Hemorrhagic manifestations were seen in all patients- a positive tourniquet test (21.2%), scattered petechial rash (23.07%), confluent rash (2.7%), epistaxis (38.4%), gum bleeds (28.06%) and hematemesis (22.86%) being the major bleeding manifestations. Hepatomegaly was observed in 96% of the patients. Laboratory investigations revealed thrombocytopenia, hemoconcentration and leukopenia. Serological confirmation with a microcapture ELISA technic was done in 143/515 patients. The mortality rate was 6.6% and, multiple bleeding manifestations, severe thrombocytopenia, hypoproteinemia and dengue shock syndrome (DSS) were associated with a higher mortality.
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PMID:The 1996 outbreak of dengue hemorrhagic fever in Delhi, India. 1043 46

The case definition for dengue hemorrhagic fever (DHF) requires fever, platelets < or = 100,000/mm3, any hemorrhagic manifestation, and plasma leakage evidenced by hemoconcentration > or = 20%, pleural or abdominal effusions, hypoproteinemia or hypoalbuminemia. We evaluated the specificity and yield of modified DHF case definitions and the recently proposed World Health Organization criteria for a provisional diagnosis of DHF, using a data base of laboratory-positive and laboratory-negative reports of hospitalizations for suspected dengue in Puerto Rico, 1994 to 1996. By design, all modifications had 100% sensitivity. More liberal criteria for plasma leakage were examined: 1) adding as evidence a single hematocrit > or = 50% (specificity 97.4%); 2) accepting hemoconcentration > or = 10% (specificity 90.1%); and 3) accepting either hematocrit > or = 50% or hemoconcentration > or = 10% (specificity 88.8%). The new DHF cases identified by these definitions (and percent laboratory positive) were 25 (100.0%), 95 (90.5%), and 107 (91.6%), respectively. In contrast, the provisional diagnosis of DHF (fever and hemorrhage, and one or more of platelets < or = 100,000/mm3, or hemoconcentration > or = 20%, or at least a rising hematocrit [redefined quantitatively as a 5% or greater relative change]) showed a specificity of 66.8%, and identified 318 new DHF cases, of which 282 (88.7%) were laboratory-positive. Very small changes in the criteria may result in a large number of new cases. The modification that accepted either hematocrit > or = 50% or hemoconcentration > or = 10% had acceptable specificity, while doubling the detection of DHF-compatible, laboratory-positive severe cases, but "provisional diagnosis" showed even lower specificity, and may produce inflated DHF incidence figures. Modified case definitions should be prospectively evaluated with patients in a health-care facility before they are recommended for widespread use.
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PMID:An evaluation of modified case definitions for the detection of dengue hemorrhagic fever. Puerto Rico Association of Epidemiologists. 1073 Mar 1

A study was undertaken to analyze the usefulness of radiographic and ultrasonographic findings and area specific hematocrit cut off values in Dengue Hemorrhagic Fever (DHF). Of the 65 cases, 35 were DHF and 30 were Dengue Fever as per the WHO case definition. Among the DHF cases, hemoconcentration (>20%) was detected in 20 cases (57.14%), hypoproteinemia in 11 (31.42%) and clinical evidence of pleural effusion and or ascites in 25 (71.42%). Hemoconcentration based on area specific hematocrit cut off values was observed in 32 cases (91.42%). Ultrasonographic evidence of plasma leakage was seen in 32 cases (91.42%). In detecting plasma leakage, area specific hematocrit cut off values and ultrasonography had the highest sensitivity (91.42%), while ultrasonography had the highest negative predictive value of 84.21%. Clinical evidence of plasma leakage was more frequent than hemoconcentration or hypoproteinuria. Ultrasonography is an ideal non-invasive investigation to detect plasma leakage and area specific hematocrit values are useful as evidence of plasma leakage.
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PMID:A reappraisal of the criteria to diagnose plasma leakage in dengue hemorrhagic fever. 1665 72

Dengue is a mosquito-borne arboviral infection that has become a public health concern in India and particularly Mumbai, where endemicity is on the rise. Fifty-seven children having dengue infection admitted over 12 months (2008) in a child health unit of a teaching hospital in Mumbai and who were positive for IgM antibodies by ELISA test were retrospectively studied for clinical profile and outcome. Common clinical findings were fever (100%), hepatomegaly (66.6%), vomiting (40.3%), and significant bleeding manifestations (38.5%). Common laboratory findings were thrombocytopenia (platelet < 100,000/mm3 in 96.5% patients), increased liver enzymes (59.6%), hypoalbuminemia (50.8%), hyponatremia (40.3%), and deranged prothrombin time/partial thromboplastin time (PT/PTT) (33.3%). Third spacing in the form of ascites and pleural effusion was present in 15.7% and 31.5% of patients, respectively. There was no correlation between platelet count and bleeding manifestation. Patients with dengue shock syndrome required more supportive therapy with blood products and inotropes and had a longer recovery time. Mortality in the study was 3.5%. PT/PTT, serum sodium, albumin, and white blood cell (WBC) counts were predictors of severity of dengue. To summarize, fever, hemorrhagic manifestations, hepatomegaly, thrombocytopenia, and evidence of plasma leakage (hemoconcentration, pleural effusion, ascites or hypoproteinemia) should lead a clinician to suspect dengue infection.
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PMID:Profile of dengue patients admitted to a tertiary care hospital in Mumbai. 2238 84