Patient characteristics
A total of 120 patients with a duration of illness of day ≤ 4 were included in this study out of which 72 individuals had DF and 48 proceeded to develop DHF based on the 2011 WHO classification of dengue disease severity (Table 1). Two patients who had DHF developed shock. All patients recovered and there were no fatalities. Six (8.3%) patients with DF and 7 (14.5%) patients with DHF had bleeding manifestations. In the patients with DF, four had vaginal bleeding and two had melena, whereas in the patients with DHF, one had melena and five had vaginal bleeding. Although 6 patients with DF had bleeding manifestations, none of them had evidence of fluid leakage and therefore, did not fulfill the criteria to be classified as DHF.
Urinary LTE4 levels in patients with acute dengue
In patients with a duration of illness of ≤ 4 days (n=120), the urinary LTE4 levels were significantly higher (p=0.004) in patients who proceed to develop DHF (median 1741, IQR 980.1-2,799 pg/mg creatinine) when compared to patients with DF (median 1178, IQR 592.6- 2,034 pg/mg creatinine)(Fig 1). Although the LTE4 levels in patients with DF was higher than in healthy individuals (median 706.6 pg/mg creatinine, IQR 535.3- 1639 pg/mg creatinine) this difference was not significant (p= 0.148). The urinary LTE4 levels were also significantly high (p=0.02) in patients with DHF (median 1755, IQR 1,102-2,875 pg/mg creatinine) on day 5 to 6 of illness compared to those with DF (median 1,263, IQR 729.9- 2,383 pg/mg creatinine) (Fig 1) .