Von Willebrand Factor Level among Sudanese Patients with Dengue Fever Disease

Backgrounds and Aims Remarkable fluctuations in von willebrand factor (VWF) was observed in dengue infection. The knowledge of VWF in patients with dengue is not clear. Due to the increased recurrence of hemorrhage this study was undertaken. A cross-sectional study was conducted to investigate quantitative aspects of VWF Ag in dengue infected patients in Port Sudan Teaching Hospital, Red Sea State, Sudan. Materials and Methods 101 patients with dengue were enrolled in this study. Laboratory-positive dengue cases were confirmed by IgM enzyme-linked immunosorbent assay test and WHO criteria were used for classifying the dengue severity. Platelet count (PLT), Plasma Prothrombin time (PT), activated partial thromboplastin time (APTT), Fibrinogen (FB), and VWF Ag were performed. Results 81 patients (80.2 %) had classic dengue fever and 20 patients (19.8 %) had dengue hemorrhagic fever (DHF), classified as 5 patients (5.0 %) had DHF I, 13 patients (12.9 %) had DHF II and two of them developed dengue shock syndrome (DSS) and died (2.0 %).92.1 % had thrombocytopenia. PT, APTT, and FB were found to be statistically significant higher in patients when compared to the controls (Pless than 0.000 and 0.001 respectively). PT was prolonged in 29.7 %, APTT was prolonged in 42.6 %, hypofibrinogenemia in 18.3 % and hyperfibrinogenemia in 67.4 % of the patients. VWF Ag was low (57.4 %) among patients compared to controls (7.9 %) (Pless than 0.001), a significant reduction in VWF Ag levels among patients presenting DF 44 (43.7 %) and entire group of DHF 14 (13.9 %). Conclusion This study indicates a positive correlation between low platelet count and the remarkable reduction of VWF Ag. However, VWF may have abnormalities when associated with dengue infection.