PATHOGENESIS OF HEMORRHAGIC DUE TO DENGUE VIRUS

Abstract

abstract Dengue is a viral disease that is mediated by a mosquito, which causes morbidity and mortality. Viruses can increase vascular permeability which can lead to hemorrhagic diathesis or disseminated intravascular coagulation (DIC) known as dengue hemorrhagic fever (DHF). In Indonesia, dengue hemorrhagic fever (DHF) are caused by dengue virus infection which was found to be endemic accompanied by an explosion of extraordinary events that appear at various specified period. The diagnosis of dengue is determined based on the criteria of the World Health Organization (WHO, 1999), which are sudden high fever accompanied by a marked tendency to hemorrhage positive tourniquet test, petechiae, ecchymosis, purpura, mucosal hemorrhagic, hematemesis or melena and thrombocytopenia. The problem that still exists today is the mechanism of thrombocytopenia in patients with varying degrees of dengue involving levels of vWF (von Willebrand factor) and prostaglandin I2 (PGI2) can not be explained. The mechanism of hemorrhagic in dengue virus infections acquired as a result of thrombocytopenia, platelet disfunction decreased coagulation factors, vasculopathy with endothelial injury and disseminated intravascular coagulation (DIC). abstrak Dengue adalah penyakit viral yang diperantarai oleh nyamuk, yang menyebabkan morbiditas dan mortalitas. Virus dapat meningkatkan permeabilitas vaskular yang dapat memicu hemorrhagic diathesis atau disseminated intravascular coagulation (DIC) yang lebih dikenal dengan demam berdarah dengue (DBD). Di Indonesia, DBD disebabkan karena infeksi virus dengue yang ditemukan untuk menjadi endemik disertai dengan suatu ledakan luar biasa dari peristiwa yang muncul di berbagai periode tertentu. Diagnosis dengue ditunjukkan berdasarkan kriteria World Health Organization (WHO, 1999), yaitu demam tinggi secara tiba-tiba yang ditandai dengan tes hemorrhage positive tourniquet, petechiae, ecchymosis, purpura, mucosal, berdarah hematemesis atau melena dan trombositopenia. Masalah yang masih ada ialah mekanisme trombositopenia di pasien dengan variasi derajat level dengue vWF (von Willebrand factor) dan prostaglandin I2 (PGI2) tidak bisa dijelaskan. Mekanisme demam berdarah dengue (DBD) pada infeksi virus dengue yang diperoleh sebagai hasil trombositopenia, platelet disfungsi, faktor koagulasi menurun, endotel vasculopathy dengan cedera serta disseminated intravascular coagulation (DIC).