Dengue : Mnemonics

Pathophysiology

Mnemonic: ABC

1. Antibody-Dependent Enhancement: Non-neutralizing antibodies (Pre-M-specific antibodies and NS1-specific antibodies) forms virus-antibody complex, which enters the host cells and replicates generating high virus titers in blood
2. Bleeding manifestations:
   • Endothelial dysfunction and plasma leakage (Anti-NS1 antibody acts as autoantibodies and cross-react with non-infected endothelial cells)
   • Coagulopathy
   • Thrombocytopenia (Bone marrow suppression + Platelet destruction)
3. Cytokine storm: CD4+ and CD8+ T cells, specific to the dengue virus, cause lysis of virus-infected cells and produce cytokines such as IFN-gamma, TNF-alpha, and lymphotoxin

Classification

Dengue Classification : Mnemonic

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Lab Diagnosis

1. NS1 antigen and RNA PCR – Detectable from day 1
2. IgM antibody:
   • Rises after 2 days of symptom onset
   • Peaks at 2 weeks
   • Normalizes by 2 months