Impaired Fibrinolysis in the Pathogenesis of Dengue Hemorrhagic Fever

van Gorp, Eric C. M. and Setiati, Tatty E. and Mairuhu, ATA and Suharti, Catharina and ten Cate, H and Dolmans, Wil M. V. and van der Meer, Jos W. M. and Hack, C. Erik and Brandjes, DPM (2002) Impaired Fibrinolysis in the Pathogenesis of Dengue Hemorrhagic Fever. Journal of Medical Virology (67). pp. 549-554.

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The mechanisms contributing to bleeding complications in dengue hemorrhagic fever were studied by investigating the pattern of activation of the coagulation and fibrinolytic systems in 50 children with severe dengue hemorrhagic fever. Thirteen patients (26%) died, and activation of coagulation was most pronounced in the deceased group. Fibrinolysis was also activated, but this activation was relatively weak compared with that of coagulation as a result of persistently high plasminogen activator inhibitor levels. Plasminogen activator inhibitor also prevented a switch from the procoagulant to the profibrinolytic state in lethal dengue hemorrhagic fever, which was further enhanced by an acquired protein C deficiency. The present study is the first to demonstrate such a mechanism in a viral infection. This imbalance between coagulation and fibrinolysis may be used as a prognostic marker, but it may also be a target for future therapeutic intervention.

Item Type:Article
Subjects:R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:Faculty of Medicine > Department of Medicine
Faculty of Medicine > Department of Medicine
ID Code:565
Deposited By:Mr. Sugeng Priyanto
Deposited On:14 Sep 2009 11:16
Last Modified:14 Sep 2009 11:16

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