Journal of Tropical Diseases & Public Health

Abstract

Prevalence of Hypocalcemia and Its Potential Value as a Biochemical Marker in Patients with Severe Dengue Infection

Madura Adikari, Charith Perera, Mihika Fernando, Mark Loeb, Sunil Premawansa, Dharshan de Silva and Gayani Premawansa

Background: Dengue infection is a major public health problem in tropical and subtropical countries including Sri Lanka, leading to significant morbidity and mortality. In severe dengue infection, plasma leakage is observed leading to numerous biochemical derangements including hypocalcemia. We studied the prevalence of hypocalcemia in a population of patients with severe dengue infection.

Methods: A prospective follow up study was conducted in a tertiary care centre in Sri Lanka throughout a one year period. World health organization 2009 criteria were used to diagnose the patients with severe dengue infection. All the patients with severe dengue infection were analyzed with serum ionized calcium during the first 24 hours of onset of the severe dengue clinical criteria.

Results: From the total population of 61 with severe dengue infection, 42(68.8%) were males and 19(31.2%) were females. Mean age of the population was 28.8 years. Among the 61 patients 52(85%) showed hypocalcemia during the first 24 hours of onset of severe dengue infection. Mean ionized calcium level of the population was 0.96 mmol/L, range being 0.53-1.48 mmol/L.

Conclusion: Serum ionized calcium level was significantly reduced in majority of patients with severe dengue infection within the first 24 hours of the onset of severe dengue clinical criteria. Value of serum ionized calcium as a biochemical marker to detect severe dengue infection early should be further explored with large scale studies.