The role of cytokines in the prognosis of children with dengue shock syndrome in Vietnam

Abstract

Dengue shock syndrome (DSS) is a severe complication of dengue hemorrhagic fever (DHF) and can lead to death, but DSS incidence and effects are difficult to predict via clinical examination. With consideration of this issue, this research determined the role of cytokines in the severity and prognosis of DHF in children. This prospective cohort research involved 234 patients who were aged 18 months to 18 years old, admitted to Tien Giang General Hospital, and diagnosed as having DHF. The cytokine levels of the patients were recorded from admission to discharge. Almost all the patients (>67%) exhibited increased interleukin 10 (IL-10), IL-6, and IL-2, whereas only 0.43% (the lowest) presented with elevated IL-12. Concentrations of IL-2, IL-4, IL-13, and tumor necrosis factor-α were highest i the patients infected with DENV-1, followed by those infected with DENV-3 and DENV-2. IL-12 concentration decreased with increasing days of fever occurrence. No correlation was found between cytokine concentrations in the first day of hospitalization and shock in the DHF patients. The concentration of cytokines during the first day of hospitalization (i.e., patients with a fever lasting less than 72 hours) cannot be used as a guide in determining DSS prognosis.