A STUDY TO EVALUATE VON WILLEBRAND FACTOR IN TROPICAL DISEASES - SCRUB TYPHUS, DENGUE, CHIKUNGUNYA, MALARIA AND ITS ASSOCIATION WITH CLINICAL OUTCOME
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 1713-1724
Abstract
Introduction: Endothelial activation and dysfunction is a central process in the pathogenesis of tropical diseases and von-Willebrand Factor levels have been linked with damage to the endothelium. The purpose of the study is to evaluate von Willebrand Factor in tropical diseases-Scrub typhus, Dengue, Chikungunya, Malaria and its association with clinical outcome. vWF can be used as a novel prognostic marker of clinical outcome.Methodology: Hospital-based prospective observational analytic study on36 subjects of each disease. Inclusion Criteria: Confirmed cases of Scrub typhus (IgM positive), Dengue (NS1/IgM positive), Chikungunya (IgM positive) and Malaria (slide positive/rapid antigen detection/severe malaria). Exclusion criteria: Patients with von-Willebrand disease, Thrombotic Thrombocytopenic Purpura, and other conditions characterized by vascular damage, including nephritis, myocardial infarction, sepsis, diabetic angiopathy, peripheral vascular disease. Complete history with the examination was done. Investigations including CBC, PBF, RBS, RFT, LFT, vWF activity were done.
Observation and Results: In our study, we observed that vWF levels were elevated in91% patients of malaria, 89% patients of dengue, 75% patients of chikungunya, 88% patients of scrub typhus. We also found that 6, 3, and 3 out of 36 patients died in Malaria, Dengue, and Scrub typhus respectively with mean vWF was 414.67 IU/dl, 420 IU/dl, and 420 IU/dl respectively against alive cases where mean vWF was 259.97 IU/dl, 272.97 IU/dl, and 233.94 IU/dl. There is a statistically significant difference in vWF among alive and dead cases.
Conclusion: Raised vWF shows the association of von- Willebrand Factor activity and its association with the complications in these tropical diseases. von- Willebrand Factor level can be used as a novel prognostic marker of clinical outcome.
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