Abstract
Background: Dengue fever is an acute febrile illness, ranging from asymptomatic to severe state in connection with hosts immune response. Several biochemical markers such as decreased platelet count, prolonged prothrombin duration, and increased hematocrit level have been recommended to evaluate disease severity. Due to lack of their clinical relevance, evaluation of serum ferritin is distinguishing feature to predict the disease severity at the early stage of infection.

Aims and Objectives: The aim of the study was to assess the levels of serum ferritin as an early predictor of infection severity in children with dengue fever.

Materials and Methods: Seventy-four patients diagnosed with dengue fever by non-structural protein 1 antigen positive and ≤12 years of age were recruited. Hematological investigation such as platelet count, C-reactive protein (CRP), complete blood picture, liver function tests, renal function tests, and serum ferritin was assessed. Cases were monitored for disease progression status and platelet count too. Categorical variables were assessed by Chi-square test and descriptive statistics were used to represent demographic data.

Results: The mean differences of the levels of platelet count, CRP, total cholesterol, triglycerides, and low-density lipoprotein were statistically significant among severe and non-severe dengue cases. Serum ferritin levels in children with severe dengue fever showed 876.42 ng/ml, 1048.94 ng/ml and 1573.20 ng/ml on 3rd, 4th, and 5th day, respectively. Whereas, cases with non-severe dengue showed 431.12 ng/ml, 612.20 ng/ml, and 698.41 ng/ml on 3rd, 4th, and 5th day, respectively.

Conclusion: Serum ferritin levels were significantly increased with severity dengue fever on 3rd, 4th, and 5th day of infection. Thus, serum ferritin is an efficient biomarker in estimating the dengue fever severity and progression at early stage of infection in children.

Key words: Dengue Fever; Serum Ferritin; Platelet Count; Disease Severity; Disease Progression