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The Levels of Troponin T in Patients with Dengue Hemorrhagic Fever

Received: 17 May 2015     Accepted: 28 May 2015     Published: 19 June 2015
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Abstract

Introduction: The incidence of myocarditis on Dengue Hemorrhagic Fever (DHF) is still controversial because the disease was asymptomatic and definitive diagnosis only with endocardial biopsy. More specific and sensitive examination to detect the cardiac disorder is cardiac enzyme likes the level of troponin T. Objective: This study aims to evaluate the level of troponin T in patients with dengue shock syndrome (DSS) and dengue hemorrhagic fever without shock. Methods: The research conducted a cross-sectional study at Child Health Department of Dr. Wahidin Sudirohusodo Hospital, Makassar, from July to October 2012. The population included children with DHF admitted to the hospital of Dr. Wahidin Sudirohusodo, Ibnu Sina and Faisal Islamic. Diagnosis of DHF was established based on history taking, physical and laboratory examination. Results: There were 70 samples who met the criteria, including 35 patients of DSS and 35 patients of dengue hemorrhagic fever without shock. The level of troponin T was higher on DSS group than DHF group with the cut off point of ≥0.007 ng/ml is the best level to distinguish between dengue shock syndrome and dengue hemorrhagic fever without shock (p=0.000, sensitivity 97.1%, specificity 88.6%, positive predictive value 89.5%, negative predictive value 96.9%,OR 18.7; 95% CI 15.3–1417.5). Conclusion: The level of troponin T was higher on DSS group than dengue hemorrhagic fever without shock group because on DSS occurs to stress caused by hypoperfusion. But the level of troponin T between two groups within normal limits, not found cardiac disorder such as myocarditis on DHF.

Published in American Journal of Clinical and Experimental Medicine (Volume 3, Issue 4)
DOI 10.11648/j.ajcem.20150304.14
Page(s) 149-153
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Troponin T Levels, Dengue Hemorrhagic Fever, Children

References
[1] Sutaryo. Dengue. Faculty of Medicine of Gajah Mada University. Yogyakarta. 2004; 1–242.
[2] Soedarmo SSP, Garna H, Hadinegoro SRS, Satari HI. Textbook of Pediatric Infectious and Tropical. 2nd Edition. Indonesian Pediatric Association: Jakarta. 2008
[3] Satari HI. Pitfalls on dengue hemorrhagic fever. Indonesian Pediatrics Association. DKI Jakarta branch. 2011; 57-69.
[4] WHO. Regional guidelines on Dengue/ DHF Prevention and Control. 2005.
[5] Rajapakse S. Dengue Shock. J Emerg Trauma Shock. 2011; 4 (1): 120-76835
[6] Gupta V K, Gadpayle AK. Subclinical cardiac involvement in dengue hemorrhagic fever. Journal Indian Academy of Clinical Medicine. 2010; 2 (2): 107-11
[7] Supachokchaiwattana P, La-orkhum V, Arj-ong S, Sirichonkolthong B, Lertsapcharoen P, Khongphatthanayothin A. Reversible impairment of global cardiac function during toxic stage of dengue hemorrhagic fever and dengue shock syndrome. Thai heart J. 2007; 20: 180-187.
[8] Baratawidjaya, K.G. Basic immunology. 7th Edition. Hall Publishers of FK-UI. Jakarta. 2006; 124-6.
[9] Abbas A K, Lichtman A H, Pillai S. Cytokine, 5th ed. Philadelpia, Pennsylvania. Elsevier Saunders. 2005; 243-53, 281.
[10] Soegiyanto S. Aspects of immunology dengue haemorrhagic fever: Overview and findings new era 2003. Surabaya: Airlangga Universitas Press. 2004; 11-25.
[11] Goh PL. Dengue Perimyocarditis: A Case Report. Hong Kong Journal of Emergency Medicine, 2010; Vol 17 (1).
[12] Chaundhary SC, Avasthi R, Mohanty D. Dengue shock syndrome- an unusual manifestation. JIACM. 2010; 11(4): 309-11.
[13] Howes DS. Myocarditis in Emergency Medicine. 2010
[14] George R. Unusual Manifestations of Dengue Virus Infections. JPOG. 1999
[15] Arif SM, Ahmed H, Khokon KZ, Azad AK, Faiz MA. Dengue haemorrhagic fever with bradycardia. J Medicine. 2009; 10: 36-37.
[16] Alam K, Sulaiman SAS, Shafie AA, Yusuf Eddy. Clinical manifestation and laboratory profile of dengue fever among the patient’s General Hospital, Penang. Archives of Pharmacy Practice. 2010; Vol.1: 25-29
[17] Lee IK, Lee WH, Liu JW, Yang KD. Acute myocarditis in dengue hemorrhagic fever: A case report and review of cardiac complication in dengue-affected patients. Elseiver. 2010
[18] Wichmann D, Kularatne S, Ehrhardt S, wijesinghe S, Bratting NW, Abel W, Buchard GD. Cardiac involvement in dengue virus infections during the 2004/2005 dengue fever season in Sri Langka. 2009
[19] Fogoros RN. Cardiac enzymes and heart attacks. About.com. Heart Health Center. 2008
[20] Kaushik J S, Gupta P, Rajpal S, Bhatt S. Spontaneous resolution of sinoatrial exit block and atrioventricular dissociation in a child with dengue fever. Singapore Med J. 2010; 51 (8): el 46-el 48
[21] Samsu N, Sargowo D. Sensitivity and specificity Troponin T and I in the diagnosis of acute myocardial infarction. Indonesia Medicine magazine. 2007; Vol. 57 (10)
[22] Nawawi RA, Fitriani, Rusli B, Hardjoeno. The value of Troponin T (cTnT) in patients with Acute Coronary Syndrome (ACS). Indonesian Journal of Clinical Pathology and Medical Laboratory. 2006; Vol. 12 (3): 123-126.
[23] Finsterer J, Stollberger C, Kruglugers W. Cardiac and noncardiac, particularly neuromuscular, disease with Troponin-T positivity. The jurnal Of Medicine Netherlands. 2007; vol. 65 (8).
[24] Kemp M, Donovon J, Higham H, Hooper J. Biochemical Markers of Myocardial Injury: British Journal of Anaesthasia. 2004; 93: 63-73.
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  • APA Style

    Burhanuddin Iskandar, Juherinah, Dasril Daud, Andi Dwi Bahagia Febriani. (2015). The Levels of Troponin T in Patients with Dengue Hemorrhagic Fever. American Journal of Clinical and Experimental Medicine, 3(4), 149-153. https://doi.org/10.11648/j.ajcem.20150304.14

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    ACS Style

    Burhanuddin Iskandar; Juherinah; Dasril Daud; Andi Dwi Bahagia Febriani. The Levels of Troponin T in Patients with Dengue Hemorrhagic Fever. Am. J. Clin. Exp. Med. 2015, 3(4), 149-153. doi: 10.11648/j.ajcem.20150304.14

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    AMA Style

    Burhanuddin Iskandar, Juherinah, Dasril Daud, Andi Dwi Bahagia Febriani. The Levels of Troponin T in Patients with Dengue Hemorrhagic Fever. Am J Clin Exp Med. 2015;3(4):149-153. doi: 10.11648/j.ajcem.20150304.14

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  • @article{10.11648/j.ajcem.20150304.14,
      author = {Burhanuddin Iskandar and Juherinah and Dasril Daud and Andi Dwi Bahagia Febriani},
      title = {The Levels of Troponin T in Patients with Dengue Hemorrhagic Fever},
      journal = {American Journal of Clinical and Experimental Medicine},
      volume = {3},
      number = {4},
      pages = {149-153},
      doi = {10.11648/j.ajcem.20150304.14},
      url = {https://doi.org/10.11648/j.ajcem.20150304.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20150304.14},
      abstract = {Introduction: The incidence of myocarditis on Dengue Hemorrhagic Fever (DHF) is still controversial because the disease was asymptomatic and definitive diagnosis only with endocardial biopsy. More specific and sensitive examination to detect the cardiac disorder is cardiac enzyme likes the level of troponin T. Objective: This study aims to evaluate the level of troponin T in patients with dengue shock syndrome (DSS) and dengue hemorrhagic fever without shock. Methods: The research conducted a cross-sectional study at Child Health Department of Dr. Wahidin Sudirohusodo Hospital, Makassar, from July to October 2012. The population included children with DHF admitted to the hospital of Dr. Wahidin Sudirohusodo, Ibnu Sina and Faisal Islamic. Diagnosis of DHF was established based on history taking, physical and laboratory examination. Results: There were 70 samples who met the criteria, including 35 patients of DSS and 35 patients of dengue hemorrhagic fever without shock. The level of troponin T was higher on DSS group than DHF group with the cut off point of ≥0.007 ng/ml is the best level to distinguish between dengue shock syndrome and dengue hemorrhagic fever without shock (p=0.000, sensitivity 97.1%, specificity 88.6%, positive predictive value 89.5%, negative predictive value 96.9%,OR 18.7; 95% CI 15.3–1417.5). Conclusion: The level of troponin T was higher on DSS group than dengue hemorrhagic fever without shock group because on DSS occurs to stress caused by hypoperfusion. But the level of troponin T between two groups within normal limits, not found cardiac disorder such as myocarditis on DHF.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - The Levels of Troponin T in Patients with Dengue Hemorrhagic Fever
    AU  - Burhanuddin Iskandar
    AU  - Juherinah
    AU  - Dasril Daud
    AU  - Andi Dwi Bahagia Febriani
    Y1  - 2015/06/19
    PY  - 2015
    N1  - https://doi.org/10.11648/j.ajcem.20150304.14
    DO  - 10.11648/j.ajcem.20150304.14
    T2  - American Journal of Clinical and Experimental Medicine
    JF  - American Journal of Clinical and Experimental Medicine
    JO  - American Journal of Clinical and Experimental Medicine
    SP  - 149
    EP  - 153
    PB  - Science Publishing Group
    SN  - 2330-8133
    UR  - https://doi.org/10.11648/j.ajcem.20150304.14
    AB  - Introduction: The incidence of myocarditis on Dengue Hemorrhagic Fever (DHF) is still controversial because the disease was asymptomatic and definitive diagnosis only with endocardial biopsy. More specific and sensitive examination to detect the cardiac disorder is cardiac enzyme likes the level of troponin T. Objective: This study aims to evaluate the level of troponin T in patients with dengue shock syndrome (DSS) and dengue hemorrhagic fever without shock. Methods: The research conducted a cross-sectional study at Child Health Department of Dr. Wahidin Sudirohusodo Hospital, Makassar, from July to October 2012. The population included children with DHF admitted to the hospital of Dr. Wahidin Sudirohusodo, Ibnu Sina and Faisal Islamic. Diagnosis of DHF was established based on history taking, physical and laboratory examination. Results: There were 70 samples who met the criteria, including 35 patients of DSS and 35 patients of dengue hemorrhagic fever without shock. The level of troponin T was higher on DSS group than DHF group with the cut off point of ≥0.007 ng/ml is the best level to distinguish between dengue shock syndrome and dengue hemorrhagic fever without shock (p=0.000, sensitivity 97.1%, specificity 88.6%, positive predictive value 89.5%, negative predictive value 96.9%,OR 18.7; 95% CI 15.3–1417.5). Conclusion: The level of troponin T was higher on DSS group than dengue hemorrhagic fever without shock group because on DSS occurs to stress caused by hypoperfusion. But the level of troponin T between two groups within normal limits, not found cardiac disorder such as myocarditis on DHF.
    VL  - 3
    IS  - 4
    ER  - 

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Author Information
  • Department of Pediatrics, Medical Faculty of Hasanuddin University, Makassar, South Sulawesi, Indonesia

  • Department of Pediatrics, Medical Faculty of Hasanuddin University, Makassar, South Sulawesi, Indonesia

  • Department of Pediatrics, Medical Faculty of Hasanuddin University, Makassar, South Sulawesi, Indonesia

  • Department of Pediatrics, Medical Faculty of Hasanuddin University, Makassar, South Sulawesi, Indonesia

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