Endocrine changes in children with dengue virus infection

ABSTRACT

Background: Dengue is a common infectious disease in Southeast Asia. The hormonal changes of dengue have rarely been studied.Objective: To demonstrate the endocrine changes in children with dengue viral infection, and to compare these changes with the severity of dengue virus infection.Materials and method: Twenty-three children (11 males and 12 females) presented with clinical features and serological confirmation of dengue fever (DF) were measured for thyroid function test (freeT4, T3 and TSH), serum cortisol and serum insulin-like growth factor-I (IGF-I) and IGF-binding protein 3 (IGFBP-3) during febrile and convalescent periods. Sixteen children (8 males and 8 females) presented with clinical features and serological confirmation of dengue hemorrhagic fever (DHF) were measured for these parameters but during shock and convalescent periods.Results: In shock period of DHF, serum T3 was lower than that in febrile period of DF (90.5±34.0 and 103.1±39.0 ng/dL) but not significantly different. Serum freeT4 had positive correlation with serum T3 during febrile period (r=0.74, p \< 0.001) in DF and during shock period (r=0.48, p=0.02) in DHF. During convalescent period, serum T3 had a positive correlation with serum TSH in DF but not in DHF. The increment of IGF-I was higher in DF than that in DHF in convalescent period. The changes represented a slower recovery of thyroid and GH-IGF axes in DHF. In addition, serum cortisol level trended to be insufficient. (\< 18 μg/dL) during febrile period in DF and shock period in DHF.Conclusion: Thyroid axis was influenced by the illness similar to changes in euthyroid sick syndrome. Insufficiency of adrenal reserve and changes of GH-IGF axis need to be further studied.