Natural regulatory anticoagulants proteins among Sudanese patients with dengue virus infection

THE COAGULATION SYSTEM Abnormalities in natural physiologic anticoagulants are observed in dengue infection. Laboratory values such as protein C (PC), protein S (PS), and antithrombin (AT) indicate this problem on the coagulation system in dengue. Recently, an interrelationship between dengue and the levels of natural anticoagulants has been observed. OBJECTIVE The study conducted to find out the effect of dengue on the natural anticoagulant proteins. METHODS A case-control study was conducted in Port Sudan Teaching Hospital from February 2013 to June 2014 for 334 cases of dengue caused by dengue virus, 217 (65%) males and 117 (35%) were females along with 101 cases of control 64 (63.4%) males and 37 (36.6%) were females. Laboratory-positive dengue cases were confirmed by immunoglobulin (Ig) M and IgG immune chromatography rapid test and the WHO criteria were used for classifying the dengue severity. Platelet count (PLT), plasma prothrombin time (PT), partial thromboplastin time (PTT), fibrinogen, D-dimer (DD), aspartate transaminase, alanine transaminase, PC, PS, and AT were performed. RESULTS Of 334, 289 patients had dengue fever (DF) and 45 patients had dengue hemorrhagic fever (DHF). Thrombocytopenia was present in 279 (83.5%). PLT was found to be significantly low in the case of dengue (P < 0.000). There was a highly significant difference between the prolongations of PT and PTT in DF (P < 0.000). Prolongations of PT and PTT were significantly higher (90% and 76.2%, respectively) in DF than DHF patients (10% and 23.8%, respectively). PC and PS were significantly higher in DHF 100% and 80% than DF 89% and 57%, respectively. CONCLUSION The findings of this study suggest that lower levels of these proteins in patients with dengue are attributed to disseminated intravascular coagulation.