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Clinical features of dengue in a large Vietnamese cohort: intrinsically lower platelet counts and greater risk for bleeding in adults than children

PLoS neglected tropical diseases, 2012-06, Vol.6 (6), p.e1679-e1679 [Peer Reviewed Journal]

COPYRIGHT 2012 Public Library of Science ;2012 Dinh The et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Dinh The T, Le Thi Thu T, Nguyen Minh D, Tran Van N, Tran Tinh H, et al. (2012) Clinical Features of Dengue in a Large Vietnamese Cohort: Intrinsically Lower Platelet Counts and Greater Risk for Bleeding in Adults than Children. PLoS Negl Trop Dis 6(6): e1679. doi:10.1371/journal.pntd.0001679 ;Dinh The et al. 2012 ;ISSN: 1935-2735 ;ISSN: 1935-2727 ;EISSN: 1935-2735 ;DOI: 10.1371/journal.pntd.0001679 ;PMID: 22745839

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Title:
Clinical features of dengue in a large Vietnamese cohort: intrinsically lower platelet counts and greater risk for bleeding in adults than children
Author: Trung, Dinh The ; Thao, Le Thi Thu ; Dung, Nguyen Minh ; Ngoc, Tran Van ; Hien, Tran Tinh ; Chau, Nguyen Van Vinh ; Wolbers, Marcel ; Tam, Dong Thi Hoai ; Farrar, Jeremy ; Simmons, Cameron ; Wills, Bridget
Halstead, Scott B.
Subjects: Adolescent ; Adult ; Age Factors ; Blood platelets ; Child ; Child, Preschool ; Children ; Cohort analysis ; Demographic aspects ; Dengue ; Dengue - complications ; Dengue - epidemiology ; Dengue - pathology ; Development and progression ; Female ; Health aspects ; Hemorrhage ; Hemorrhage - epidemiology ; Hospitals ; Humans ; Infant ; Male ; Measurement ; Medicine ; Methods ; Prospective Studies ; Risk Assessment ; Risk factors ; Thrombocytopenia - epidemiology ; Vietnam - epidemiology ; Young Adult
Is Part Of: PLoS neglected tropical diseases, 2012-06, Vol.6 (6), p.e1679-e1679
Description: As dengue spreads to new geographical regions and the force of infection changes in existing endemic areas, a greater breadth of clinical presentations is being recognised. Clinical experience suggests that adults manifest a pattern of complications different from those observed in children, but few reports have described the age-related spectrum of disease in contemporaneous groups of patients recruited at the same geographical location. Using detailed prospectively collected information from ongoing studies that encompass the full spectrum of hospitalised dengue cases admitted to a single hospital in southern Vietnam, we compared clinical and laboratory features, management, and outcome for 647 adults and 881 children with confirmed dengue. Signs of vascular leakage and shock were more frequent and more severe in children than adults, while bleeding manifestations and organ involvement were more common in adults. Additionally, adults experienced significantly more severe thrombocytopenia. Secondary infection but not serotype was independently associated with greater thrombocytopenia, although with a smaller effect than age-group. The effect of age-group on platelet count was also apparent in the values obtained several weeks after recovery, indicating that healthy adults have intrinsically lower counts compared to children. There are clear distinctions between adults and children in the pattern of complications seen in association with dengue infection, and these depend partly on intrinsic age-dependent physiological differences. Knowledge of such differences is important to inform research on disease pathogenesis, as well as to encourage development of management guidelines that are appropriate to the age-groups at risk.
Publisher: United States: Public Library of Science
Language: English
Identifier: ISSN: 1935-2735
ISSN: 1935-2727
EISSN: 1935-2735
DOI: 10.1371/journal.pntd.0001679
PMID: 22745839
Source: Public Library of Science (PLoS) Journals Open Access
Freely Accessible Journals
MEDLINE
PubMed Central
ProQuest Central
DOAJ Directory of Open Access Journals

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Clinical features of dengue in a large Vietnamese cohort: intrinsically lower platelet counts and greater risk for bleeding in adults than children

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