Analysis of gene expression profile and construction of ceRNA regulatory network after DENV-2 infection with HUVECs / 西安交通大学学报(医学版)

【Objective】 To establish a co-expression lncRNA-mRNA ceRNA network and explore the potential molecular mechanism of lncRNA in dengue fever. 【Methods】 DENV-2-infected and normal pHUVEC were sequenced and screened for differentially expressed lncRNA and mRNA by gene microarray technology. Differentially expressed mRNA was analyzed by protein-protein interaction (PPI), and significantly related co-expressed lncRNA-mRNA was screened by Pearson’s correlation coefficient. The microRNA (miRNA) that bound to co-expressed lncRNA-mRNA was predicted by the database. The ceRNA network of co-expressed lncRNA-mRNA was constructed by Cytoscape software. Finally differentially expressed mRNAs and co-expressed lncRNA-mRNA were analyzed by GO and KEGG enrichment, and co-expressed lncRNA-mRNA was verified by RT-qPCR. 【Results】 At 48 h and 72 h after infection, 105 and 51 differentially expressed mRNAs were obtained, respectively, while 59 and 29 differentially expressed lncRNAs were obtained, respectively. Furthermore, at the two time intervals, there were 10 differential mRNAs and 5 differential lncRNAs, respectively. PPI analysis of differential mRNAs showed that isocratic values of interleukin 6 (IL6), interferon-induced protein with tetratricopeptide repeats 2 (IFIT2), and 2’-5’-oligoadenylate synthetase 2 (OAS2) were relatively high. The pairing results of lncRNA-mRNA co-expression analysis with the highest correlation coefficients at 48 h and 72 h after infection were XLOC_001966-SMTNL1 and XLOC_001966-ESR2, respectively. According to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis, the functions of differentially expressed mRNA and co-expressed lncRNA-mRNA were mainly involved in virus epidemic prevention response, immune response, and signal transduction, as well as the Janus kinase (JAK)-signal transducer and activator of transcription (STAT) signaling pathway, type I interferon, and cytokine receptor interaction. RT-qPCR revealed that lncRNA XLOC-I2-8991 was upregulated in the co-expressed lncRNA-mRNA, whereas all the other lncRNA and mRNA were downregulated. 【Conclusion】 This study initially revealed the potential lncRNA-mRNA co-expression network during dengue virus infection, and found that co-expressed lncRNA-mRNA was mainly enriched in the immune regulation and signal transduction pathways during virus infection. The findings will help further exploration into the infection mechanism of DENV-2.

A Study of Serum Ferritin Level in Patients of Dengue Fever and Its Correlation with the Severity of Dengue Fever in Tertiary Care Hospital of South Gujarat

Introduction: In more than 100 endemic countries, there are 50 to 100 million new cases reported per year, according to the WHO. The dengue pandemic has caused significant death. There is usually only supportive care offered and no effective therapy. The purpose of the study was assess any effect on the level of serum ferritin in patients of dengue. Methodology: This was an observational, Prospective study conducted at Surat Municipal Institute of Medical Education and Research General Medicine department among dengue fever cases. Result: Serum ferritin level from on admission then on day 3 and then day 5 in non-severe and severe dengue cases showed p value <0.001 which was statically significant. Conclusion: The use of a serum ferritin level alone with a cut-off value of more than 900 ng/ml is indicated.

Managing severe thrombocytopenia in co-infection of COVID-19 and dengue hemorrhagic fever: a case report

COVID-19 pandemic in dengue endemic countries has becoming a concern due to its similarities in early clinical symptoms and laboratory features. The cases of co-infection between the two diseases are inevitable and associated with higher morbidity and mortality. Here we presented a case of a 28 years old female diagnosed with co-infection of COVID-19 and dengue hemorrhagic fever that complicated with severe thrombocytopenia and spontaneous bleeding.She came with fever that started 3 days prior to admission. Laboratory examination showed leucopenia, thrombocytopenia, elevated liver enzymes, and D-dimer. Patient tested positive for non-structural protein 1 (NS-1)dengue antigen. She had a pre-screening rapid test for COVID-19 as part of hospital protocol, and she tested positive. Followed by positive COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR)test confirmingthe diagnosis. During admission, patient started menstruating, resulting in active spontaneous bleeding while platelet counts dropped to below 10×109/l. Patient was given platelet transfusion, supportive therapy and put under close monitoring. The case ofco-infection between COVID-19 and dengue is inevitable in tropical and sub-tropical countries. Both infections shared similar pathophysiology through different mechanism, such as plasma leakage, thrombocytopenia, and coagulopathy.Complications may arise and physician must aware of the therapeutical approach. Diagnostic testing must not be withheld when there was suspicion towards the infection. Prompt treatment and close monitoring can result in good prognosis.

Serum Lactate as a Predictor of Severity in Dengue Infection

Background Dengue infections caused by the four antigenically distinct dengue virus serotypes (DENV1, DENV2, DENV3, DENV4) of the family Flaviviridae are the most major arboviral diseases in humans in terms of geographic spread, morbidity, and mortality. Objective: The study was conducted to assess serum lactate in cases of dengue and correlate it with severity in dengue infection. Methodology: A prospective observational study was carried out among indoor patients admitted to the general medicine department of the tertiary care hospital SMIMER Surat. The study's duration was 15 to 18 months. Result: our study found out of total 154 cases; majority of cases were belonged from 83(53.90%) cases were from less than 30 years. male was contributed 96 (62.34%), majority of cases had duration of fever 39(25.32%), 66 (42.66%) case had high LDH, comparison of serum lactate dehydrogenase with severity of dengue mean lactate dehydrogenase of dengue without severity was mean was 148.45 and SD 11.81, while in severe dengue mean serum lactate dehydrogenase 388.23 and SD 99.47 with p value 0.001 which was statically significant. Conclusion According to this study, it is preferable to monitor serial lactate levels as opposed to using a single lactate number.

Clinical profile of dengue fever infection in patients admitted in NC Medical College, Haryana in the year 2019

Background: Dengue infections can result in a wide spectrum of disease severity ranging from an influenza-like illness (dengue fever; DF) to the life-threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). The study was aimed to compare the clinical profile of all patients diagnosed with dengue viral infection at NCMC.Methods: This retrospective study included 24 patients infected with dengue virus, aged 19 years to 45 years. Laboratory and haematological data were included.Results Peak of infection occurred in November 2019 and no cases were recorded in October 2019. Common clinical symptoms were fever, joint pains, headache and rash. Common haematological abnormalities were thrombocytopenia. All patients survived. There was no case of dengue hemorrhagic fever or dengue shock syndrome.Conclusions: Significant differences in the clinical profile is possibly because of infection with different serotypes of dengue virus (DENV), concurrent/sequential infection of more than one serotype, and differences in host immune responses associated with host genetic variations.

Dengue in pregnancy, maternal and fetal outcome: a case series managed at a Zonal Hospital

Background: Dengue is a vector borne disease with various grades of severity. Pregnancy is a high-risk group and is prone for complications of dengue haemorrhagic fever. The aim of this study was to evaluate the clinical profile of pregnant patients with dengue and to assess the maternal and fetal outcomes of dengue in pregnancy.Methods: All pregnant patients reporting to the hospital with fever and serologically confirmed dengue infection were included in the study. Clinical and laboratory data of patients were collected. The cases were followed up till their delivery to monitor the effect of dengue. An account of the mode of delivery in these patients was made. The neonates were evaluated and followed up till 6 weeks of life.Results: A total 100% patients reported with fever and serologically confirmed dengue infection. 15% had severe thrombocytopenia requiring platelet transfusion. 31% required ICU care and 15% needed mechanical respiratory support due to severe complications of dengue. NICU admission rate was 30% but there was no major neonatal complication or vertical transmission noted. A high index of suspicion should be maintained by the clinician with an aim to identify infection early, start supportive treatment and evaluate for complications. In-patient care should be provided for feto-maternal monitoring.Conclusions: The progression of dengue infection in pregnancy was rapid leading to major complications. Close materno-fetal monitoring and timely obstetric care are essential to ensure a favorable pregnancy outcome

Acute Kidney Injury in Non-Shock Dengue Hemorrhagic Fever

@#INTRODUCTION: Acute kidney injury (AKI) is one of the severe complications in dengue hemorrhagic fever, usually occurred in shock. We report an interesting case of AKI in a hemodynamically stable dengue hemorrhagic fever patient. CASE PRESENTATION: An 18-year-old male dengue fever patient referred to our institution in his day eight of illness due to three days of decreased urine output. He was hemodynamically stable with thrombocytopenia, increase in creatinine, positive for Anti dengue IgM, proteinuria, and hematuria. Ultrasound examination showed ascites. He was diagnosed with AKI stage III related to dengue hemorrhagic fever and underwent hemodialysis. A total of four series of hemodialysis and furosemide drip were performed during 12 days of admission and he was finally improved. CONCLUSION: Renal injury might occur in hemodynamically stable dengue hemorrhagic patients. It is a reversible condition; hence, appropriate treatment and close monitoring result in good outcomes

Clinical and hematological profile in dengue

Background: Dengue is the most rapidly spreading mosquito-borne viral disease. The spectrum ranges from a nonspecific febrile illness to severe disease, i.e., dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) with the development of hematological complications. Since the death in these patients is due to hematological complications, their study would have a substantial impact on reducing the mortality and morbidity associated with dengue. Objective: The objective of this study was to evaluate the hematological changes in serologically positive dengue patients and to correlate the same with different stages of serology and clinical outcome. Materials and Methods: Evaluation of the hematological parameters and peripheral smear study in clinically suspected cases of dengue with serological confirmation was carried out. Clinical data along with the outcome were collected from medical records. Chi-square test, somatosensory evoked potential, and logistic regression analysis were applied to analyze the results. Results: Three hundred and forty-eight serologically positive dengue cases were analyzed. The disease manifested as dengue fever (DF) in 83.5% of cases, DHF in 10.6% of cases, and DSS in 4.9% of cases. Thrombocytopenia was the most common hematological finding followed by anemia, leukopenia, leukocytosis, and increased hematocrit. Peripheral smears showed atypical lymphocytes, neutrophilic toxic granules, giant platelets, and granulocytic shift to left. About 94.26% of patients recovered and 3.45% had fatal outcome. Conclusion: Platelet count and hematocrit play a crucial role in predicting prognosis of DHF and DSS. Thrombocytopenia was associated more with DHF and DSS than DF. There was a significant association between decreased platelet count and mortality rate.

Clinical spectrum of dengue at a tertiary care hospital in Eastern India

Background: Dengue is a vector borne disease by four different serotypes of dengue virus transmitted by bite of female Aedes mosquito. It is an acute febrile illness characterised by myalgia, joint pain, gastrointestinal manifestations. Complications like dengue hemorrhagic fever (DHF) and Dengue shock syndrome (DSS) , Extended Dengue Syndrome(EDS) may be fatal for patients. Authors analyse different clinical spectrum of of manifestations, complications and correlation bleeding to platelet level.Methods: This study conducted from July 2017 to December 2018 comprising of 100 dengue patients of age more than 15 years in IMS & SUM Hospital.Result: Out of 100 dengue patients’ males 73% and females 27%. From the patients 57% were NS1 Antigen positive, 29% IgM positive, 9% NS1 and IgM positive, 4% IgM and IgG positive and 2 % with all NS1, IgM, IgG positive. In our series in clinical manifestations, all cases (100%) presented with fever, myalgia (78%), headache (53%), rashes (14%), nausea, pain abdomen (21%) loose motion (17%), and Retro-orbital pain (6%). Bleeding manifestations in any form was seen in 39% cases like Purpura or Petechie (23%), malena (18%), hematemesis ( 2% ), epixtasis (6%), Gum bleeding (2%), Hematuria (1%), and Ophthalmic bleeding like sub conjunctival hemorrhage, intra-vitreal hemorrhage in 8% cases. Complications detected e.g. hepatopathy in 53%, nephropathy. 4%, ascites 8%, pneumonia 7%, DSS (4%), Multi Organ Dysfunction (MODS) (4%), DHF (8%) and EDS in 2% cases. It was observed that 95.8% of patients with platelet counts between 20,000-50,000/cu.mm and 61% of patients less than 25000 had bleeding manifestations.Conclusion: Wide clinical spectrum of manifestations and complications makes it common differential diagnosis of acute febrile illnesses and bleeding manifestation does not always corelate with lower platelet count.

Immature platelet fraction in children infected with dengue fever

Background: Millions are infected with dengue every year.' Early diagnosis of dengue infection is important for proper treatment of DHF and DSS to avoid fatal outcome. Thrombocytopenia is a common hematological abnormality in dengue, which demands platelet transfusion in most of the severe dengue cases. Platelet transfusion though life-saving has its own hazards. Hence, we can use some new parameter like immature platelet fraction (IPF) which is a measure of reticulated platelets that reflects the rate of thrombopoiesis. The risk of platelet transfusion may be decreased by rapid identification of immature platelet fraction. This study was performed to establish reference of IPF values for the assessment of thrombopoiesis.Methods: Blood samples from 150 children were obtained on day of illness 3, 5 and 7. The IPF is identified by sysmex XE2100 hematology analyser in the reticulocyte channel using a fluorescent dye and a carefully designed gating system and counted by a special software termed IPF master7. IPF values against platelet count were assessed separately on day 3, 5 and 7.Results: The reference intervals of IPF > 8 % and IPF < 8 % were assessed against platelet count. Increase in IPF favored increase in platelet count on day 5 which was statistically significant with the p value <0.001.Conclusions: A rapid and inexpensive automated measurement of IPF can be integrated as a standard parameter to evaluate the thrombopoietic state of the bone marrow. From the study it can be concluded that IPF is an important predictor of increase in platelet count.' Increase in IPF>8 % suggests that platelet count will be increased in next 24 to 48hrs indicating that further blood transfusion will not be required.

Predictive factors of dengue severity in hospitalized children and adolescents in Rio de Janeiro, Brazil

Abstract INTRODUCTION: Dengue is one of the most important mosquito-borne infections. Severe cases are more frequently observed in adults. However, in 2008, the State of Rio de Janeiro, Brazil, experienced a severe dengue epidemic that primarily affected children and caused many cases of dengue hemorrhagic fever (DHF) and death. METHODS: A cross-sectional analytical study was conducted to examine laboratory diagnosis and clinical epidemiologic factors for confirmed dengue cases in patients aged less than 16 years, from January to June 2008, at a municipal hospital in the City of Rio de Janeiro, Brazil. Variables associated with severe outcomes and P values less than .05 were evaluated by means of a logistic regression model. RESULTS: Of the 419 dengue cases studied, 296 were classified as DHF and 123 as classical dengue. Six patients who had DHF died. In multivariate analysis, some laboratory and clinical variables were independently associated with DHF: age 5 years or older (odds ratio [OR], 4.94; 95% confidence interval [CI], 1.30-18.71), abdominal pain (OR, 8.59; 95% CI, 3.17-23.27), hepatomegaly (OR, 15.87; 95% CI, 5.38-46.85), and positive tourniquet test (OR, 10.84; 95% CI, 3.96-29.71). Hypoalbuminemia occurred more frequently than hemoconcentration in DHF cases, and high aminotransferase levels were associated with severity. CONCLUSIONS: Age greater than 5 years, abdominal pain, painful hepatomegaly, and positive tourniquet test were predictors of DHF. The high frequency of hepatic impairment suggests that acetaminophen should be avoided in severe cases of dengue.

Research Progress of Chemical Drugs Against Dengue Virus / 中国药学杂志

Dengue fever is one of the most important vector-borne human diseases caused by mosquito vectorAedes aegypti and Aedes albopictus. Dengue virus can cause dengue fever, dengue hemorrhagic fever and dengue shock syndrome. There are no approved drugs for the treatment of dengue disease so far. According to the mechanism of anti-dengue virus(anti-DENV) action, drugs under development for dengue disease can be divided into two categories: viral replication inhibitors and anti-cell factor pathway inhibitors. The former is further divided into DENV entry inhibitors, capsid protein inhibitors, NS3 protein inhibitors, NS5 protein inhibitors, and NS4B protein inhibitors; the latter is further divided into cell receptor inhibitors, lipid synthesis and metabolism inhibitors, and glucosidase inhibitors. The R&D of anti-DENV drugs is facing enormous challenges. Development of effective drugs which can be used for the treatment of four serotypes of dengue has a broad application prospect, and it will bring new hopes for dengue fever prevention and therapy.

Dengue fever may mislead the surgeons when it presents as an acute abdomen

OBJECTIVE@#To review the management experience of a consecutive series of patients presenting as acute surgical abdomen whom were ultimately diagnosed to have DF (Dengue fever)/DHF (Dengue hemorrhagic fever).@*METHODS@#Clinical data of all cases of apparent acute abdomen (AA) which were later confirmed as having DF/DHF reviewed by two surgical units from December 2012 to December 2013 were analyzed. Initially confirmed patients with DF/DHF who developed abdominal symptoms were not considered.@*RESULTS@#Out of the seventeen cases (7 males, age range 10-71 years) presented with fever and AA; appendicitis, cholecystitis, pancreatitis and non-specific peritonitis were suspected initially in 8, 5, 1 and 3 cases, respectively. Neutropenia or thrombocytopenia signifying DF/DHF occurred only in 11 patients at first evaluation thus six remained as surgical candidates beyond 24 h. One patient underwent appendicectomy with a prolonged hospital stay. DF was confirmed by serology in all patients, latest by fourth day of admission. One required blood product transfusion, 4 needed critical care treatment and there was 1 death.@*CONCLUSIONS@#DF/DHF misleads the clinicians when it presents as AA. Initial hematological and ultrasonographic findings may be equivocal creating a diagnostic and management dilemma. Vigilant clinical suspicion and early dengue serological assessment is advisable in equivocal cases of AAs with fever in dengue endemic areas, to confirm/exclude the infection in order to avoid unnecessary surgical morbidity in the presence of DF.

Soluble Fas Ligand as a Potential Marker of Severity of Dengue Infection

Background: The apoptosis of microvascular endothelial cells causes plasma leakage in dengue haemorrhagic fever patients. The soluble Fas ligand is a protein with molecular weight of 40 kDa that acts as a mediator of apoptosis. This study aimed to prove whether soluble Fas ligand can be used as a potential marker to predict the severity of dengue infection by comparing the soluble Fas ligand levels in dengue fever (DF) and dengue haemorrhagic fever (DHF) patients early in the course of illness. Method: This was a prospective study. It included 42 dengue patients (22 DF patients and 20 DHF patients) and 20 healthy people as a control group. The soluble Fas ligand was measured by the enzyme-linked immunosorbent assay (ELISA). Result: Soluble Fas ligand was increased significantly (P < 0.001) in DHF patients (median = 130.19, IQR = 36.26) compared to DF patients (median = 104.73, IQR = 53.94) and the control group (median = 87.16, IQR = 24.91). Conclusion: Soluble Fas ligand can be used as a potential marker to predict the severity of dengue infection in the early course of the illness. However, a larger sample size and further objective studies are needed to confirm these findings.

Dengue fever may mislead the surgeons when it presents as an acute abdomen

Objective To review the management experience of a consecutive series of patients presenting as acute surgical abdomen whom were ultimately diagnosed to have DF (Dengue fever)/DHF (Dengue hemorrhagic fever). Methods Clinical data of all cases of apparent acute abdomen (AA) which were later confirmed as having DF/DHF reviewed by two surgical units from December 2012 to December 2013 were analyzed. Initially confirmed patients with DF/DHF who developed abdominal symptoms were not considered. Results Out of the seventeen cases (7 males, age range 10–71 years) presented with fever and AA; appendicitis, cholecystitis, pancreatitis and non-specific peritonitis were suspected initially in 8, 5, 1 and 3 cases, respectively. Neutropenia or thrombocytopenia signifying DF/DHF occurred only in 11 patients at first evaluation thus six remained as surgical candidates beyond 24 h. One patient underwent appendicectomy with a prolonged hospital stay. DF was confirmed by serology in all patients, latest by fourth day of admission. One required blood product transfusion, 4 needed critical care treatment and there was 1 death. Conclusions DF/DHF misleads the clinicians when it presents as AA. Initial hematological and ultrasonographic findings may be equivocal creating a diagnostic and management dilemma. Vigilant clinical suspicion and early dengue serological assessment is advisable in equivocal cases of AAs with fever in dengue endemic areas, to confirm/exclude the infection in order to avoid unnecessary surgical morbidity in the presence of DF.

Acute pancreatitis complicating dengue hemorrhagic fever

Abstract Dengue infection can have spectrum of manifestations, often with an unpredictable clinical progression and outcome. There have been increasing reports of atypical manifestations. Abdominal pain or tenderness and persistent vomiting (warning signs) are present in the majority of cases with severe dengue prior to clinical deterioration. We report a 10-year-old child who presented with fever, persistent vomiting, and abdominal pain. A diagnosis of acute pancreatitis was made. This is a very infrequently reported complication of dengue hemorrhagic fever.

Complete Heart Block in Association with Dengue Hemorrhagic Fever

Dengue virus infection affects the heart structurally and functionally. Clinical manifestations of cardiac complications secondary to dengue virus infection vary from self-limiting arrhythmias to severe myocardial infarction, leading to hypotension, pulmonary edema, and cardiogenic shock. However, we report a case of dengue hemorrhagic fever (DHF) complicated by a complete heart block. A female with DHF due to dengue virus serotype 2, presented to the emergency department with fever, headache, rash, and fatigue followed by an episode of syncope. She was found to have a third-degree atrioventricular block, with pulseless polymorphic ventricular tachycardia. Patient was resuscitated and a temporary trans-venous pacemaker was placed. She reverted back to normal sinus rhythm after 4 days of syncope and was subsequently discharged from the hospital after complete resolution of symptoms, without the need for a permanent pacemaker. Physicians are warranted to have high index of suspicion for dengue virus infection as an etiology in patients with acute cardiovascular compromise, especially in tropical areas.

Dengue presenting as Acute Liver Failure A case report

Background: Dengue is the most common arboviral illness in humans. It is transmitted by mosquitoes of the genus Aedes, which are widely distributed in subtropical and tropical countries. The dengue virus has four related but antigenically distinct serotypes: DENV-1, DENV-2, DENV-3, and DENV-4. Many patients with dengue experience a prodrome of chills and facial flushing, which may last for 2-3 days. Other symptoms may include headache, retro-orbital pain, severe myalgias, nausea and vomiting, maculopapular or macular confluent rash over the thorax with islands of skin sparing, weakness, altered taste sensation, anorexia, sore throat, hemorrhagic manifestations (e.g. petechiae, bleeding gums, epistaxis and hematuria) and lymphadenopathy. The incubation period is 3-14 days. Criteria for the diagnosis of dengue hemorrhagic fever, according to the World Health Organization (WHO), are as follows: Fever, Hemorrhagic manifestations (e.g. hemoconcentration, thrombocytopenia, and positive tourniquet test), Circulatory failure, such as signs of vascular permeability (e.g. hypoproteinemia, effusions) and Hepatomegaly. Aim: To know the atypical manifestations of Dengue such as acute liver failure, seizures and encephalopathy. Material and methods: Study material obtained from Columbia Asia hospital Patiala along with all the records and detailed history of the patient. The study was carried out in Intensive Care Unit of the hospital where the patient was admitted. Observation and conclusion: In our case, patient presented with Dengue Hemorrhagic Fever. He developed acute liver failure which was considered to be due to dengue infection as antigen for the same was positive and other viral markers were negative. Acute liver failure manifested in the form of raised liver enzymes, coagulopathy, and encephalopathy. Dengue can lead to mild to moderate elevation of liver enzymes but complication of acute liver failure is rare.

Severe dengue in the early postoperative period after kidney transplantation: two case reports from Hospital Geral de Fortaleza

Abstract: Dengue is an arbovirosis that ranges from an asymptomatic presentation to a more severe disease, which is characterized by a vascular leakage syndrome where abdominal pain is a major symptom. Transplant recipients are immunosuppressed and are less likely to develop a severe form of the disease because of a reduction in immune-mediated responses that trigger plasma extravasation events. Herein, we report two cases of severe dengue in the early postoperative period of two kidney transplant recipients. Considering the severity of the cases, we emphasize the importance of dengue screening immediately before transplantation in areas endemic for the disease.

Status of circulating immune complexes, IL8 titers and cryoglobulins in patients with dengue infection.

Dengue, a serious viral infection caused by the mosquito vector, Aedes aegyptii, affects about 390 million people annually from more than 125 countries across the globe. However, until now, there is no reliable clinical or laboratory indicator to accurately predict the development of dengue severity. Here, we explored critical pathophysiological determinants like IL8, circulating immune complex (CIC) and cryoglobulin in dengue-infected patients for identification of novel dengue severity biomarker(s). Totally, 100 clinically suspected dengue cases were tested by NS1 ELISA and MAC ELISA for dengue virus aetiology. For control, 49 healthy volunteers were included. Blood profiling (complete hemogram and liver function test) of patient population were done using automated cell counter and standard auto analyzer based biochemical analysis. Serum CIC was quantified by PEG precipitation. Serum cryoglobulins were estimated by Folin assay. Levels of serum IL-8 were assessed by standard sandwich ELISA kits. Patient CIC were further characterized by SDS Gel electrophoresis. Forty per cent of the cases tested positive, of which 11 patients had severe clinical manifestation. The mean ±SEM of cryoglobulin concentration for DHF, DF, and HC were 1.30±0.31, 0.59±0.08 and 0.143±0.009 μg/μl, respectively. Thus, DHF and DF patients have shown 9- and 2.2-fold increase in cryoglobulin levels; and 18- and 5-fold increased CIC, respectively compared to HC patients. The mean ±SEM of CIC-PEG index for DHF, DF and HC were 491±41.22, 146±14.19 and 27.98±2.56, respectively. Raised levels of IL8 titers were also found in all 11 DHF patients. Peak levels of CIC, cryoglobulin and IL8 titers were associated with thrombocytopenia. SDS PAGE analysis of CIC from DHF revealed the presence of at least six protein bands that were not observed in samples from DF and HC. Prediction efficacy of IL8, CIC and cryoglobulin for DHF was determined using the receiver operator characteristic curve (ROC). The area under the curve was 1.00 for IL8, 0.99 for CIC and 0.74 for cryoglobulins. Overall, the results suggest that CIC, IL-8 and cryoglobulins may serve as important laboratory parameters to monitor dengue infection progression.