[Plasma leakage detection in severe dengue: when serum albumin quantification plays a role?]. / Evidência de alterações de permeabilidade vascular na dengue: quando a dosagem de albumina sérica define o quadro?

Evidence of vascular leakage due to increased capillary permeability characterizes and differentiates dengue hemorrhagic fever. This article assesses the value of serum albumin for detecting vascular permeability abnormalities in dengue cases. Fourteen patients diagnosed with dengue hemorrhagic fever at two private hospitals in Recife, Brazil, between January and May 2002 were followed up with daily hematocrit and serum albumin assays. Ultrasound scans and chest X-rays were also performed. Eight (57%) of the cases presented hemoconcentration of 20% or more. Hypoalbuminemia was detected in ten patients (71%). Serum albumin assays increased the detection of permeability abnormalities in six cases (43%) in which the hemoconcentration was less than 20% and the symptoms were compatible with an exacerbated immune response. The X-rays were normal in all cases. Thus, the use serum albumin quantification increased the sensitivity of dengue hemorrhagic fever detection.

Evidência de alterações de permeabilidade vascular na dengue: quando a dosagem de albumina sérica define o quadro? / Plasma leakage detection in severe dengue: when serum albumin quantification plays a role?

Evidência de extravasamento vascular decorrente do aumento da permeabilidade capilar caracteriza e diferencia febre hemorrágica da dengue. Este artigo avalia o valor de albumina sérica na detecção de alterações de permeabilidade vascular em casos de dengue. Quatorze pacientes diagnosticados com febre hemorrágica da dengue em dois hospitais privados em Recife, Brasil, entre janeiro e maio de 2002 foram seguidos com dosagens diárias de hematócrito e albumina sérica. Ultra-son e Raio X de tórax foram realizados. Oito (57 por cento) casos apresentaram hemoconcentração de 20 por cento ou mais. Hipoalbuminemia foi detectado em dez (71 por cento) pacientes. Dosagem de albumina sérica aumentou a detecção de alterações de permeabilidade em seis (43 por cento) casos na qual a hemoconcentração foi inferior a 20 por cento e os sintomas foram compatíveis com um a resposta imune exacerbada. Raio-X foi normal em todos os casos. A utilização, portanto, de dosagem de albumina sérica aumenta a sensibilidade de detecção de casos de febre hemorrágica da dengue.

Evidence of vascular leakage due to increased capillary permeability characterizes and differentiates dengue hemorrhagic fever. This article assesses the value of serum albumin for detecting vascular permeability abnormalities in dengue cases. Fourteen patients diagnosed with dengue hemorrhagic fever at two private hospitals in Recife, Brazil, between January and May 2002 were followed up with daily hematocrit and serum albumin assays. Ultrasound scans and chest X-rays were also performed. Eight (57 percent) of the cases presented hemoconcentration of 20 percent or more. Hypoalbuminemia was detected in ten patients (71 percent). Serum albumin assays increased the detection of permeability abnormalities in six cases (43 percent) in which the hemoconcentration was less than 20 percent and the symptoms were compatible with an exacerbated immune response. The X-rays were normal in all cases. Thus, the use serum albumin quantification increased the sensitivity of dengue hemorrhagic fever detection.