Effect of dengue hemorrhagic fever on thrombomodulin level

Main Article Content

Hendra Widjaja
Max F. J. Mantik


Background Thrombocyte and endothelial cells play an
important role in dengue hemorrhagic fever pathogenesis.
Thrombomodulin is a part of glycoprotein membrane in
endothelial cells. Therefore, thrombomodulin level will
increase if endothelial cells disruption occurs.
Objective To acknowledge the correlation between the
degree of dengue hemorrhagic fever and thrombomodulin
Methods This was a cross-sectional study. Subjects were
hospitalized pediatric patients with age ranging from one
to 13 year old in pediatric ward at Pro£ Dr. R.D. Kandou
Hospital, Manado, who had fever. Three milliliters of blood
were taken from vein, and were divided for two tests which
were routine blood analysis and thrombomodulin analysis.
Different data resulted from the dengue hemorrhagic fever
group were processed, and analyzed statistically using F Test
and LSD (least significant difference) test. The relation
between dengue hemorrhagic fever and thrombomodulin
was analyzed with Spearman correlation coefficient.
Results There was a significant result in the difference of
thrombomodulin level on four dengue hemorrhagic fever
groups which were classified according to the severity of
dengue hemorrhagic fever. There was a very significant
positive correlation between the severity of dengue
hemorrhagic fever and thrombomodulin level in detecting
endothelial cells impairment.
Conclusion Thrombomodulin level can be used as a
marker to detect endothelial cells impairment in dengue
hemorrhagic fever. Higher grade of dengue hemorrhagic
fever will have higher thrombomodulin level.

Article Details

How to Cite
Widjaja H, Mantik M. Effect of dengue hemorrhagic fever on thrombomodulin level. PI [Internet]. 31Oct.2009 [cited 27Nov.2020];49(5):259-3. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/580
Author Biographies

Hendra Widjaja

Department of Child Health, Medical School, Sam Ratulangi University, Prof. R. D. Kandou General Hospital, Manado, Indonesia.

Max F. J. Mantik

Department of Child Health, Medical School, Sam Ratulangi University, Prof. R. D. Kandou General Hospital, Manado, Indonesia.
Received 2016-09-11
Accepted 2016-09-11
Published 2009-10-31


1. Loho T. lg M anti-dengue in diagnose dengue infection. In:
Nelwan KHH, Sosrosumihardjo RF, editors. Update infection
disease. Jakarta: FKUI, 1994; 15-8.
2. Sumarmo. Dengue haemorrhagic fever in child [Dissertation].
Jakarta: University oflndonesia; 1983.
3. Glibber DJ. Dengue and dengue hemorrhagic fever. Cirn
Microbial Rev 1998;11:1-14.
4. Samsi TK. Clinical manifestation of classic dengue. In:
Firmansyah A, Sastroasmoro S, Trihono PT, editors. Abstract
ofKONIKA XI. Jakarta: Indonesian Pediatric Society, 1999;
5. WHO. Dengue haemorrhagic fever: Diagnosis, treatment,
prevention and control. 2nd edition. Geneva: WHO;
6. Samsi TK, Susanto I, Wulur H, Ruspandji T. Diagnose
of dengue hemorrhagic fever problematic. Cermin Dunia
Kedokteran. 1992;81:44-9.
7. WHO. Guidelines for treatment dengue fever/dengue
hemorrhagic fever in small hospital. Geneva: WHO, 1999;
8. WHO. Technical guidelines for diagnosis, treatment,
surveillance, prevention and control of dengue hemorrhagic
fever. Geneva: Advisory committee on dengue hemorrhagic
fever for South-East Asian and Western Pacific region; 1975.
9. CDC. Dengue and dengue hemorrhage fever information
for health care practitioners. San Juan Puerto Rico: CDC;
10. WHO. Dengue fever in Indonesia [homepage on the
internet]. c2004 [updated 2004 March 5]. Available from:
http://www.who int/csr/don/2004-03-U5/en.
11. Sutaryo. Dengue in Yogyakarta. In: Medika. Yogyakarta:
Gadjah Mada University, 2004; 184-207.
12. Dussart P, Labeau B, Lagathu G. Evaluation of an enzyme
immunoassay for detection of dengue virus NS 1 antigen in
human serum. J Clin Vaccine lmmunol. 2006;13:1185-9.
13. Matheus S, Meynard JB, Lacoste V. Use of capillary blood
samples as a new approach for diagnosis of dengue virus
infection. J Clin Microbial. 2007;45:887-90.
14. Franchini G, Ambinder RF, Barry M. Viral disease in
hematology. Hematology. 2000; 1: 409.
15. Lin CF, Chiu SC, Hsiao YL. Expression of cytokine,
chemokine, and adhesion molecules during endothelial
cell activation induced by antibodies against dengue virus
nonstructural protein 1. J lmmunol. 2005; 174:395-403.
16. Wei HY, Jiang LF, Fang DY. Dengue virus type 2 infects
human endothelial cells through binding of the viral envelope
glycoprotein to cell surface polypeptides. J Gen Viral.
17. Talavera D, Castillo AM, Dominguez MC. IL8 release,
tight junction and cytoskeleton dynamic reorganization
conducive to permeability increase are induced by dengue
virus infection of microvascular endothelial monolayers. J
Gen Viral. 2004;85: 1801-13.
18. Lee YR, Liu MT, Lei HY, Liu HS. MCP-1, a highly expressed
chemokine in dengue hemorrhagic fever/dengue shock
syndrome patients, may cause permeability change, possibly
through reduced tight junctions of vascular endothelium
cells. J Gen Viral. 2006;87:3623-30.
19. Abeyama K, Stern DM, Ito Y. The N-terminal domain
of thrombomodulin sequesters high-mobility group-B 1
protein, a novel antiinflammatory mechanism. J Clin Invest.
2005; 115:1267-74.
20. Rabausch K, Bretschneider E, Sarbia M. Regulation of
thrombomodulin expression in human vascular smooth
muscle cells by COX-2-derived prostaglandins. Circ Res.
21. Fink LM, Eidt JF, Johnson K. Thrombomodulin activity and
localization. J Dev Bioi. 1993:221-6.
22. Soeatmadji JW. Pemeriksaan-pemeriksaan untuk deteksi
disfungsi endothelial. Forum Diagnostikum. 2000;4: 1-1 1.
23. Butthep P, Chunhakan S, Tangnararachakit K. Elevated
soluble thrombomodulin in febrile stage related to patients
at risk for dengue shock syndrome. Pediatr Infect Dis.
2006; 10:894-7.
24. Wills BA, Oragui EE, Stephens AC. Coagulation abnormalities
in dengue hemorrhagic fever serial investigations
in 167 Vietnamese children with dengue shock syndrome.
Clin Infect Dis. 2002;35:277 -85.