Activation of endothelial cells, coagulation and fibrinolysis in children with Dengue virus infection

摘要: Dengue virus causes a febrile illness: fever (DF), and less frequently life-threatening hemorrhagic (DHF). Although severe bleeding remains major cause of death in DHF, the pathogenesis is poorly understood. This prospective cohort study was designed to determine extent activation endothelial cells hemostatic system correlation with clinical severity, also detect best prognostic factor(s) for DHF. Endothelial cell activation, coagulation, anticoagulant fibrinolysis parameters were measured 42 children infections (20 DF 22 DHF) during three phases illness. In DHF patients, phase, von Willebrand factor antigen (vWF:Ag), tissue (TF) plasminogen activator inhibitor (PAI-1) significantly elevated, while platelet counts ADAMTS 13 (a disintegrin metalloprotease thrombospondin repeats) low compared patients. During toxic soluble thrombomodulin (sTM), (t-PA) PAI-1 increased, thrombin activatable (TAFIa) Abnormal vWF multimers seen only For injury release procoagulant components, coagulation cascade generation, increased antifibrinolytic factors consumption natural anticoagulants, each appeared play an important role development hemorrhage Using logistic regression analysis, we found plasma VWF:Ag be indicator progression