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Von Willebrand Factor and Thrombocytopenia in Patients with Dengue Haemorrhagic Fever

: The clinical manifestation of DHF includes mild or marked febrile syndromes with abrupt onset of headache, pain behind the eyes, muscle and bone pain, nausea, vomiting and rash. The pathophysiology of DHF in human is complex involving endothelial cell activation and the impaired endothelial barrier leading to plasma leakage triggering the activation of the haemostatic system. The objective of this study was to determine Von Willebrand Factor levels and platelet effects on the vascular endothelium in patients with dengue haemorrhagic fever. Fifty patients (males 34, females 16), were recruited, Grade 1 (n=41), Grade 2 (n=6), Grade 3 (n=2) and Grade 4 (n=1) DHF. Twenty patients at seventeen years and below (Grade 1) were compared with 21 adults (Grade 1) showed no statistical differences and grouped together for analysis. Blood sampling to determine haemoglobin, haematocrit, platelets and Von Willebrand Factor (VWF) at the febrile, defervescence and convalescent phases was performed. The patients were aged between 4 and 54 years old with Grade 2 patients being significantly older (P=0.03) than Grade 1 DHF. Comparisons between Grades 1 and 2 DHF showed no statistical differences in the parameters studied. Thrombocytopenia, elevated VWF levels from normal was evident in all phases suggesting endothelial activation. In Grades 3 and 4 DHF, thrombocytopenia, elevated VWF was also seen. No mortality was observed in the study. Endothelial activation was evident in dengue haemorrhage fever.