The Use of Simple Laboratory Parameters in the Differential Diagnosis of Acute-Phase Zika and Dengue Viruses.
Acute Disease
Adult
Aspartate Aminotransferases
/ blood
Biochemistry
/ methods
Clinical Laboratory Techniques
/ methods
Dengue
/ blood
Dengue Virus
Diagnosis, Differential
Disease Outbreaks
Female
Hematology
/ methods
Humans
Male
Polynesia
Predictive Value of Tests
ROC Curve
Retrospective Studies
Young Adult
Zika Virus
Zika Virus Infection
/ blood
Arbovirus
Dengue
Differential diagnosis
Laboratory parameters
Zika
Journal
Intervirology
ISSN: 1423-0100
Titre abrégé: Intervirology
Pays: Switzerland
ID NLM: 0364265
Informations de publication
Date de publication:
2019
2019
Historique:
received:
06
08
2018
accepted:
08
03
2019
pubmed:
16
7
2019
medline:
18
12
2019
entrez:
16
7
2019
Statut:
ppublish
Résumé
Differential diagnosis between acute-phase Zika and dengue is challenging because of a similar clinical presentation and the lack of available molecular diagnosis tools in most of endemic areas. Our study aimed to evaluate the use of simple laboratory parameters to differentiate these infections. We retrospectively compared simple hematology and biochemistry values in 81 and 341 patients with confirmed Zika and dengue, respectively, collected from June 2013 to March 2014 during the French Polynesia outbreaks. Thrombocytopenia, neutropenia, leukopenia, lymphopenia, and elevated aspartate aminotransaminases were significantly more frequent in dengue than in Zika (p < 0.001). Platelets <100 × 109/L, neutrophils <0.5 × 109/L, lymphocytes <0.5 × 109/L, and aspartate aminotransaminases >100 IU/mL were found in dengue but not in Zika. The positive predictive value of the -association of leukocytes <4 × 109/L + lymphocytes <1 × 109/L + aspartate aminotransaminases >40 IU/mL for the diagnosis of dengue was 90%, with an accuracy of 82.4%. For the differential diagnosis between acute-phase Zika and dengue, there is no specific standard laboratory pattern. We identified cutoff values and a combination of laboratory parameters that are a strong argument against Zika and in favor of dengue.
Sections du résumé
BACKGROUND
BACKGROUND
Differential diagnosis between acute-phase Zika and dengue is challenging because of a similar clinical presentation and the lack of available molecular diagnosis tools in most of endemic areas.
OBJECTIVES
OBJECTIVE
Our study aimed to evaluate the use of simple laboratory parameters to differentiate these infections.
METHODS
METHODS
We retrospectively compared simple hematology and biochemistry values in 81 and 341 patients with confirmed Zika and dengue, respectively, collected from June 2013 to March 2014 during the French Polynesia outbreaks.
RESULTS
RESULTS
Thrombocytopenia, neutropenia, leukopenia, lymphopenia, and elevated aspartate aminotransaminases were significantly more frequent in dengue than in Zika (p < 0.001). Platelets <100 × 109/L, neutrophils <0.5 × 109/L, lymphocytes <0.5 × 109/L, and aspartate aminotransaminases >100 IU/mL were found in dengue but not in Zika. The positive predictive value of the -association of leukocytes <4 × 109/L + lymphocytes <1 × 109/L + aspartate aminotransaminases >40 IU/mL for the diagnosis of dengue was 90%, with an accuracy of 82.4%.
CONCLUSION
CONCLUSIONS
For the differential diagnosis between acute-phase Zika and dengue, there is no specific standard laboratory pattern. We identified cutoff values and a combination of laboratory parameters that are a strong argument against Zika and in favor of dengue.
Identifiants
pubmed: 31307046
pii: 000499567
doi: 10.1159/000499567
doi:
Substances chimiques
Aspartate Aminotransferases
EC 2.6.1.1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
51-56Informations de copyright
© 2019 S. Karger AG, Basel.