Recently, a strong correlation between high concentration of
tumor necrosis factor (TNFa) in blood and severity of dengue
hemorrhagic fever/dengue shock syndrome has been reported from
Asia and the Pacific. We wished to determine if a similar
relationship could be found in dengue patients in the Americas
where adult patients with severe syndromes have been observed
more frequently than in Asia where severe cases have been
observed mostly among children.
The concentrations of interleukin-1 (IL-1beta) in
hospistalized adult groups were significantly lower than that in
outpatient adults. In contrast, the levels of interleukin 6
(IL-6) were significantly higher in hospitalized adults and
children than in the corresponding outpatients. Levels of TNFa
were higher in hospistalized children than in outpatient children
or hospistalized adults. There was no significant difference in
the levels of these three cytokines among hospitalized patients
with or without hemorrhagic manifestations. Thus, an elevated
IL-6 level was positively associated with severity of dengue
infection in both children and adults, but IL-1beta level was
negatively associated with severity in adults.