{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T14:54:05Z","timestamp":1785941645787,"version":"3.56.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Dengue is a major cause of pediatric hospitalization in tropical countries and low- and middle-income countries (LMICs), where early recognition of severe disease remains challenging. Severe dengue is characterized by dysregulated immune activation and systemic inflammation, leading to organ dysfunction. Ferritin, an acute-phase reactant, has been increasingly studied as a potential biomarker of dengue severity, although pediatric data from LMIC settings remain limited. The aim of this study was to assess the prevalence of hyperferritinemia among children admitted with dengue with warning signs and severe dengue, and to correlate ferritin levels with clinical outcomes including organ dysfunction, new-onset multiple organ dysfunction syndrome, thrombocytopenia, need for ventilation, pediatric intensive care unit (PICU) admission, and duration of hospital stay. This single-center prospective observational study included children aged 1\u2009month\u201318\u2009years admitted to the pediatric ward or PICU with dengue with warning signs or severe dengue over a 6-month period. Serum ferritin was measured at admission. Demographic, clinical, and laboratory data were collected and analyzed. Among the 52 enrolled children, 42 (80.8%) had dengue with warning signs and 10 (19.2%) had severe dengue. Hyperferritinemia was observed in 26\/42 (61.9%) children with warning signs and in 9\/10 (90%) children with severe dengue. When stratified using a ferritin cutoff of 3000\u2009\u03bcg\/l, children with ferritin \u22653000\u2009\u03bcg\/l had significantly lower platelet counts during hospital stay (P-value\u2009=\u2009.004), increased hematological (P-value\u2009=\u2009.002) and respiratory dysfunction (P-value\u2009=\u2009.044), and a higher proportion of severe dengue cases (P-value\u2009=\u2009.01). Hyperferritinemia is common among hospitalized children with dengue and is associated with thrombocytopenia and organ dysfunction, supporting ferritin as a marker of disease severity.<\/jats:p>","DOI":"10.1093\/tropej\/fmag049","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:38:50Z","timestamp":1783571930000},"source":"Crossref","is-referenced-by-count":0,"title":["Hyperferritinemia in hospitalized children with dengue\u2014a prospective observational study"],"prefix":"10.1093","volume":"72","author":[{"given":"Liya","family":"Varghese","sequence":"first","affiliation":[{"name":"All India Institute of Medical Sciences , Nagpur, Maharashtra, 441124,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2136-3164","authenticated-orcid":false,"given":"Abhijit","family":"Choudhary","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences , Nagpur, Maharashtra, 441124,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7745-5327","authenticated-orcid":false,"given":"Megha","family":"Jayachandran","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences , Nagpur, Maharashtra, 441124,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apurva","family":"Bhoyar","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, All India Institute of Medical Sciences , Nagpur, Maharashtra, 441124,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishwajeet","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, All India Institute of Medical Sciences , Nagpur, Maharashtra, 441124,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash","family":"Bang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences , Nagpur, Maharashtra, 441124,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shikha","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences , Nagpur, Maharashtra, 441124,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Urmila","family":"Dahake","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences , Nagpur, Maharashtra, 441124,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5165-0009","authenticated-orcid":false,"given":"Meenakshi","family":"Girish","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, All India Institute of Medical Sciences , Nagpur, Maharashtra, 441124,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"2026080510163207200_fmag049-B1","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1139\/cjm-2020-0572","article-title":"Dengue virus: epidemiology, biology, and disease aetiology","volume":"67","author":"Roy","year":"2021","journal-title":"Can J Microbiol"},{"key":"2026080510163207200_fmag049-B2","volume-title":"Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control","author":"World Health Organization","year":"2009"},{"key":"2026080510163207200_fmag049-B3","volume-title":"National Guidelines for Clinical Management of Dengue Fever","author":"Ministry of Health and Family Welfare, Government of India","year":"2023"},{"key":"2026080510163207200_fmag049-B4","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1128\/CMR.00035-09","article-title":"Dengue virus pathogenesis: an integrated view","volume":"22","author":"Martina","year":"2009","journal-title":"Clin Microbiol Rev"},{"key":"2026080510163207200_fmag049-B5","first-page":"832","article-title":"Serum ferritin levels in children with dengue infection","volume":"39","author":"Chaiyaratana","year":"2008","journal-title":"Southeast Asian J Trop Med Public Health"},{"key":"2026080510163207200_fmag049-B6","doi-asserted-by":"crossref","first-page":"e3214","DOI":"10.1371\/journal.pntd.0003214","article-title":"Hyperferritinaemia in dengue virus infected patients is associated with immune activation and coagulation disturbances","volume":"8","author":"van de Weg","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"key":"2026080510163207200_fmag049-B7","doi-asserted-by":"crossref","first-page":"e409\u201316","DOI":"10.1097\/PCC.0000000000003250","article-title":"Hyperferritinemia in severe dengue infection: single-center retrospective cohort study","volume":"24","author":"Lakshmanan","year":"2023","journal-title":"Pediatr Crit Care Med"},{"key":"2026080510163207200_fmag049-B8","doi-asserted-by":"crossref","first-page":"4041","DOI":"10.1182\/blood-2011-03-278127","article-title":"How I treat hemophagocytic lymphohistiocytosis","volume":"118","author":"Jordan","year":"2011","journal-title":"Blood"},{"key":"2026080510163207200_fmag049-B9","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s15010-014-0683-4","article-title":"Ferritin levels predict severe dengue","volume":"43","author":"Soundravally","year":"2015","journal-title":"Infection"},{"key":"2026080510163207200_fmag049-B10","doi-asserted-by":"crossref","first-page":"132","DOI":"10.18535\/jmscr\/v8i1.16","article-title":"Serum ferritin as a biomarker to predict disease severity in dengue infection","volume":"8","author":"Kanitkar","year":"2020","journal-title":"J Med Sci Clin Res"},{"key":"2026080510163207200_fmag049-B11","doi-asserted-by":"crossref","first-page":"7","DOI":"10.47009\/ajcpn.2020.8.3.2","article-title":"Ferritin as a marker of severe dengue in children","volume":"8","author":"Sekhar","year":"2020","journal-title":"AJCPN"},{"key":"2026080510163207200_fmag049-B12","first-page":"548","article-title":"Rescue therapy with intravenous immunoglobulin in severe refractory dengue: a pilot study","volume":"11","author":"Padmaprakash","year":"2022","journal-title":"J Family Med Prim Care"},{"key":"2026080510163207200_fmag049-B13","first-page":"475","article-title":"Immunomodulatory therapy in dengue","volume":"60","author":"Bhat","year":"2023","journal-title":"Indian Pediatr"},{"key":"2026080510163207200_fmag049-B14","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1097\/01.PCC.0000149131.72248.E6","article-title":"International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics","volume":"6","author":"Goldstein","year":"2005","journal-title":"Pediatr Crit Care Med"},{"key":"2026080510163207200_fmag049-B15","doi-asserted-by":"crossref","first-page":"889196","DOI":"10.3389\/fimmu.2022.889196","volume":"13","year":"2022","journal-title":"Front Immunol"}],"container-title":["Journal of Tropical Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/tropej\/article-pdf\/72\/4\/fmag049\/68732287\/fmag049.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/tropej\/article-pdf\/72\/4\/fmag049\/68732287\/fmag049.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T14:16:43Z","timestamp":1785939403000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/tropej\/article\/doi\/10.1093\/tropej\/fmag049\/8728795"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,6,11]]}},"URL":"https:\/\/doi.org\/10.1093\/tropej\/fmag049","relation":{},"ISSN":["0142-6338","1465-3664"],"issn-type":[{"value":"0142-6338","type":"print"},{"value":"1465-3664","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8]]},"published":{"date-parts":[[2026,6,11]]},"article-number":"fmag049"}}