1744. The Evaluation of Endothelial Dysfunction in Crimean-Congo Hemorrhagic Fever Patients
Session: Poster Abstract Session: Viral Infections; Pathogenesis and Epidemiology
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background: The endothelium plays a key role in Crimean-Congo Hemorrhagic Fever (CCHF). The endothelium occupies a significant place in hemostasis and thrombosis mechanisms. The purpose of our study was to investigate serum markers of endothelial dysfunction [asymmetric dimethyl arginine (ADMA), endothelin-1 (ET-1), thrombomodulin (TM), von Willebrand factor (wWf) and intercellular adhesion molecule-1 (ICAM-1)] in CCHF patients, and to analyze their correlations with hemorrhage.

Methods: Thirty-six patients diagnosed with CCHF with hemorrhage and 37 patients with CCHF but without hemorrhage under observation in the our clinic were included.

Results: There was a statistically significant difference in ADMA, ET-1, TM, vWf and ICAM-1 levels between the study and control groups at time of presentation. The only statistically significant difference between the hemorrhage and non-hemorrhage groups was between TM and vWf. On the fifth day of clinical observation, with the exception of ICAM-1, the differences between the other four biomarkers were statistically significant. Biomarkers above or below specific cut-off values were significant in terms of showing hemorrhage at different degrees of sensitivity and specificity.

To interpret the data we obtained, while serum ADMA levels are low in the days when dysfunction in the endothelium is still not severe, in the days that follow they rise in direct proportion to severity of endothelial dysfunction. TM is the most striking of these biomarkers in showing endothelial damage. TM declines since it is used to prevent coagulation as a response to endothelial dysfunction at the onset of the disease. However, its levels rose in the days that followed in direct correlation with degree of dysfunctions.

Conclusion: Markers of levels of endothelial dysfunction in CCHF vary in correlation with the damage in the endothelium. Clarification with further studies of the reasons why although ADMA and TM levels were lower than in the control group, particularly at a time when endothelial damage is mild, they rose as the severity of damage worsened, will be a guide to disease prognosis and treatment.

Mustafa Arslan, Infectious Diseases and Clinical Microbiology, Karadeniz Technical University, Faculty of Medicine,, Trabzon, Turkey, Gurdal Yilmaz, Department of Infectious Diseases and Clinical Microbiology, Karadeniz Tech Univ Faculty of Med, Trabzon, Turkey, Ahmet Mentese, Vocational School of Health Sciences,, Medical Laboratory Program, Karadeniz Technical University,, Trabzon, Turkey and Iftihar Koksal, Karadeniz Tech Univ Faculty of Med, Trabzon, Turkey


M. Arslan, None

G. Yilmaz, None

A. Mentese, None

I. Koksal, None

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