Displaying publications 1 - 20 of 49 in total

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  1. Ross IN, Madhavan HN, Tan SH, Abdul Rahim K
    Med J Malaysia, 1985 Dec;40(4):301-6.
    PMID: 3025569
    Serological markers were used to determine the infective agents causing acute viral hepatitis in 246 patients. The frequencies of the five viral infections investigated were: non-A, non-B hepatitis - 99 patients (40.2%); hepatitis A - 98 patients (39.8%); hepatitis B - 43 patients (17.5%); cytomegalovirus - 4 patients (1.6%); and Epstein-Barr virus - 2 patients (0.8%). The log mean ages of presentation for the three predominant infections were: hepatitis A - 18 years; hepatitis B - 25 years; and non-A, non-B hepatitis - 30 years (F = 18.8, p =< 0.001). 52% of all cases were Malays (expected 32. 7%); 32% Chinese (expected 54.6%); and 16% Indians (expected 1l.5%) (X2 = 53, p = < 0.001). Hepatitis A virus infection was more common amongst Malays whilst non-A, non-B hepatitis was more frequent amongst Chinese and Indians. 28% of children <16 years) and 50% of adults had serological markers of previous hepatitis B infection. The variation in frequency for the different forms of hepatitis amongst the three main ethnic groups would suggest that socioeconomic and/or cultural factors are important in the propagation of acute viral hepatitis in Malaysia. HBsAg-negative chronic liver disease in our community may be a product of the high incidence of non-A, non-B hepatitis.
    Matched MeSH terms: Hepatitis A/epidemiology
  2. Jikal M, Mori D, Yusoff AF, Rai SB, Mukhsam MH, Ali I, et al.
    Am J Trop Med Hyg, 2021 07 12;105(3):777-782.
    PMID: 34255740 DOI: 10.4269/ajtmh.21-0036
    Foodborne outbreaks of hepatitis A virus (HAV) are most commonly associated with fresh and frozen produce and with various types of shellfish. Alcoholic beverage-borne outbreaks of hepatitis A are extremely rare. Here, we report an outbreak of hepatitis A associated with the consumption of a traditional wine at a funeral ceremony in the Sabah state of Malaysian Borneo. Confirmed cases were determined by serum anti-HAV immunoglobulin M and/or for fecal HAV by reverse transcription polymerase chain reaction (RT-PCR). The amplicons of RT-PCR were subjected to nucleotide sequencing followed by phylogenetic analysis. We conducted a 1:2 case-control study to identify the possible exposure that led to the outbreak. Sixteen patients met the case definition, they were 18 to 58 years old and 90% of them were males. The case-control study showed that the consumption of nipa palm wine during the ceremony was significantly associated (P = 0.0017) with hepatitis A infection (odds ratio, 5.44; 95% CI, 1.80-16.43). Untreated river water was used to dilute the traditional wine, which was assumed to be the source of the infection. Phylogenetically, these viruses belonged to genotype IA and formed an independent cluster with strains from Taiwan, Japan, and the Philippines. This strain might be an emerging HAV in Asian countries. Environmental assessments were performed and environmental samples were negative for HAV. The incidence of hepatitis A in Sabah was also determined and it was 0.795/100,000 population. Strict monitoring of traditional wine production should be implemented by the local authority to prevent future outbreaks.
    Matched MeSH terms: Hepatitis A/etiology; Hepatitis A/epidemiology*
  3. Nilashi M, Ahmadi H, Shahmoradi L, Ibrahim O, Akbari E
    J Infect Public Health, 2018 10 04;12(1):13-20.
    PMID: 30293875 DOI: 10.1016/j.jiph.2018.09.009
    BACKGROUND: Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. Supervised data mining techniques have been successful in hepatitis disease diagnosis through a set of datasets. Many methods have been developed by the aids of data mining techniques for hepatitis disease diagnosis. The majority of these methods are developed by single learning techniques. In addition, these methods do not support the ensemble learning of the data. Combining the outputs of several predictors can result in improved accuracy in classification problems. This study aims to propose an accurate method for the hepatitis disease diagnosis by taking the advantages of ensemble learning.

    METHODS: We use Non-linear Iterative Partial Least Squares to perform the data dimensionality reduction, Self-Organizing Map technique for clustering task and ensembles of Neuro-Fuzzy Inference System for predicting the hepatitis disease. We also use decision trees for the selection of most important features in the experimental dataset. We test our method on a real-world dataset and present our results in comparison with the latest results of previous studies.

    RESULTS: The results of our analyses on the dataset demonstrated that our method performance is superior to the Neural Network, ANFIS, K-Nearest Neighbors and Support Vector Machine.

    CONCLUSIONS: The method has potential to be used as an intelligent learning system for hepatitis disease diagnosis in the healthcare.

    Matched MeSH terms: Hepatitis A
  4. Alshawsh MA, Abdulla MA, Ismail S, Amin ZA
    PMID: 21647311 DOI: 10.1155/2011/103039
    Orthosiphon stamineus as medicinal plant is commonly used in Malaysia for treatment of hepatitis and jaundice; in this study, the ethanol extracts were applied to evaluate the hepatoprotective effects in a thioacetamide-induced hepatotoxic model in Sprague Dawley rats. Five groups of adult rats were arranged as follows: Group 1 (normal control group), Group 2 Thioacetamide (TAA) as positive control (hepatotoxic group), Group 3 Silymarin as a well-known standard drug (hepatoprotective group), and Groups 4 and 5 as high and low dose (treatment groups). After 60-day treatment, all rats were sacrificed. The hepatotoxic group showed a coarse granulation on the liver surface when compared to the smooth aspect observed on the liver surface of the other groups. Histopathological study confirmed the result; moreover, there was a significant increase in serum liver biochemical parameters (ALT, AST, ALP, and Bilirubin) and the level of liver Malondialdehyde (MDA), accompanied by a significant decrease in the level of total protein and Albumin in the TAA control group when compared with that of the normal group. The high-dose treatment group (200 mg/kg) significantly restored the elevated liver function enzymes near to normal. This study revealed that 200 mg/kg extracts of O. stamineus exerted a hepatoprotective effect.
    Matched MeSH terms: Hepatitis A
  5. Mohd Hanafiah K, Garcia ML, Barnes NC, Anderson DA
    BMC Res Notes, 2018 Oct 01;11(1):688.
    PMID: 30285838 DOI: 10.1186/s13104-018-3799-2
    OBJECTIVE: To conduct a proof-of-concept study on preferential binding of polymeric IgA (pIgA) using a novel recombinant rabbit/human chimeric secretory component (cSC) and preliminary assessment of the diagnostic potential of virus-specific pIgA in discriminating acute hepatitis A, E, and C (HAV, HEV, HCV) patients and uninfected controls using an indirect enzyme-linked immunoassay.

    RESULTS: cSC binds > 0.06 μg/ml of purified human and mouse pIgA with negligible cross-reactivity against IgM and IgA. Virus-specific pIgA was significantly higher in serum of acute HAV (n = 6) and HEV (n = 12) patients than uninfected samples (HEV: p 

    Matched MeSH terms: Hepatitis A/blood*; Hepatitis Antibodies/blood*
  6. Khan H., Aamir K., Arya A.
    MyJurnal
    Introduction: Systemic inflammation is the major clinical problem which is constellation of communicable and non-communicable infection equipped with acute to chronic inflammation. It may lead to unfavourable conditions for instance, systemic inflammatory syndrome, burns and sepsis. Systemic inflammation might rotate the steering towards vital clinical maladies including cardiomyopathy, neuroinflammation, hepatitis, liver and kidney diseases and even diabetes. In order to elucidate the molecular insights in these clinical implications, there is an intensive need
    to design rodent model of systemic inflammation having close association with systemic inflammatory conditions in humans. Methods: Presently, lipopolysaccharide (LPS) induced systemic inflammatory rodent model is widely established, reproducible and acceptable among scientists. In this model animals are treated with intraperitoneal injection of LPS ranging from 1-10 mg/kg which leads to instant release of proinflammatory cytokines to provide robust model of systemic inflammation in order to elucidate pathological conditions and their in-depth mechanism to uncover the new anti-inflammatory therapeutic targets. Conclusion: Robust model would open new window to explore anti-inflammatory activities of phytochemicals, small molecules and drug candidates along with crosstalk of different signaling pathways at molecular level.
    Matched MeSH terms: Hepatitis A
  7. Barzaga BN
    Vaccine, 2000 Feb 18;18 Suppl 1:S61-4.
    PMID: 10683551
    A review of the epidemiology of hepatitis A virus (HAV) infection over the last 20 years shows shifting patterns in the prevalence of antibodies to HAV (anti-HAV) throughout South-East Asia and China. A number of countries have shifted from high to moderate and from moderate to low endemicity, with a corresponding increase in the age of exposure from childhood to early adulthood. The changes have resulted from improvements in hygiene, sanitation and the quality of drinking water, reflecting improvements in living standards and socioeconomic progress. In general in the late 1970s and early 1980s, 85-95% of the population of developing countries like the Philippines, Korea, China and Thailand were anti-HAV-positive by age 10-15 years, compared with only about 50% in the more affluent countries like Malaysia and Singapore. In the early 1990s, 85-95% of the population were immune by age 30-40 years in the Philippines, Korea, China and Thailand, and by 50 years of age and above in Malaysia and Singapore. Similar trends were noted in Hong Kong, Taiwan and Japan. Exposure to HAV at a later age may be associated with an increase in hepatitis A morbidity and a greater propensity for outbreaks.
    Matched MeSH terms: Hepatitis A/epidemiology*
  8. Scelo G, Muller DC, Riboli E, Johansson M, Cross AJ, Vineis P, et al.
    Clin Cancer Res, 2018 Nov 15;24(22):5594-5601.
    PMID: 30037816 DOI: 10.1158/1078-0432.CCR-18-1496
    Purpose: Renal cell carcinoma (RCC) has the potential for cure with surgery when diagnosed at an early stage. Kidney injury molecule-1 (KIM-1) has been shown to be elevated in the plasma of RCC patients. We aimed to test whether plasma KIM-1 could represent a means of detecting RCC prior to clinical diagnosis.Experimental Design: KIM-1 concentrations were measured in prediagnostic plasma from 190 RCC cases and 190 controls nested within a population-based prospective cohort study. Cases had entered the cohort up to 5 years before diagnosis, and controls were matched on cases for date of birth, date at blood donation, sex, and country. We applied conditional logistic regression and flexible parametric survival models to evaluate the association between plasma KIM-1 concentrations and RCC risk and survival.Results: The incidence rate ratio (IRR) of RCC for a doubling in KIM-1 concentration was 1.71 [95% confidence interval (CI), 1.44-2.03, P = 4.1 × 10-23], corresponding to an IRR of 63.3 (95% CI, 16.2-246.9) comparing the 80th to the 20th percentiles of the KIM-1 distribution in this sample. Compared with a risk model including known risk factors of RCC (age, sex, country, body mass index, and tobacco smoking status), a risk model additionally including KIM-1 substantially improved discrimination between cases and controls (area under the receiver-operating characteristic curve of 0.8 compared with 0.7). High plasma KIM-1 concentrations were also associated with poorer survival (P = 0.0053).Conclusions: Plasma KIM-1 concentrations could predict RCC incidence up to 5 years prior to diagnosis and were associated with poorer survival. Clin Cancer Res; 24(22); 5594-601. ©2018 AACR.
    Matched MeSH terms: Hepatitis A Virus Cellular Receptor 1/blood*
  9. Chin M, Chin F
    Med J Malaysia, 1973 Mar;27(3):195-7.
    PMID: 4268923
    Matched MeSH terms: Hepatitis A/complications; Hepatitis A/drug therapy
  10. Amirullah Mohd Arshad, Rohaya A. Rahman, Mohd Jusoh, Fatimah Muda
    MyJurnal
    In August 2000, the Disease Control Unit of T erengganu noted an increase in the number of serologically confirmed cases of hepatitis A virus (HAH in Kuala Terengganu Hospital. Preliminary investigation revealed that there were an outbreak of hepatitis A in districts of Kuala Terengganu and Marang. Eventually, a total of 334 associated cases were reported among Kuala Terengganu residents and 59 cases among residents of Marang. The age of the patients range j9·om 2 years to 71 years old (median 16 years). Males accounted for ( 69.5% of cases and had a higher sex specyic attack rate (96.35/100,000) than females (42. 70/100,000). The highest attack rate (128.3/100,000} occurred among patients aged 10 — 14 years. The health staff of Kuala Terengganu and Marang District Health Ojice had investigated a total of 229 case. Most cases (62.4%) occurred amongst school children. A case control study was carried out amongst 35 cases that were matched with 71 controls by age group, class and sex, to identyy the potential source of injection. The results indicated that eating fried noodle with shelh‘ish significantly increased the risk of being infected during the outbreak (OR 16.38[4.2l-74.53]).
    Matched MeSH terms: Hepatitis A; Hepatitis A virus
  11. Darrat M, Flaherty GT
    PMID: 31548898 DOI: 10.1186/s40794-019-0094-8
    Background: Older people represent a significant proportion of overseas travellers. The epidemiology of older international travellers is not well described in the literature. This study aims to identify demographics, travel characteristics and the medical profile of older travellers seeking pre-travel health advice in a specialist travel medicine clinic.

    Methods: Records of travellers aged 60 years and older attending the Tropical Medical Bureau clinic in Galway, Ireland between 2014 and 2018 were examined. Descriptive and inferential.analysis of data was performed.

    Results: A total of 337 older travellers sought pre-travel health advice during the study period. The mean age of the cohort was 65.42 (±10) years. Most of the travellers (n = 267, 80%) had at least one travelling companion. Nearly half of older travellers (n = 155, 46.8%) were travelling with a single companion. Tourism was the main reason for travel for the majority (n = 260, 77.6%), followed by visiting friends and relatives (VFR) (n = 23, 6.9%) travellers. The mean interval remaining before the planned trip was 4.36 (±2) weeks, and the mean duration of travel was 3.16 (±1) weeks. The most popular single country of destination was India with 33 (9.8%) visitors, and South East Asia was the most popular region with 132 (39.2%) older travellers. The majority of travellers (n = 267, 79.2%) had a documented pre-existing medical condition. The most commonly reported medical conditions were hypertension (n = 26, 7.7%), dyslipidaemia (n = 18, 5.3%), diabetes mellitus (n = 12, 3.5%), insect bite sensitivity (n = 11, 3.3%), and hypothyroidism (n = 9, 2.6%). Antihypertensive agents (n = 32, 9.4%) and statins (n = 24, 7.1%) were the most frequently used medications. Typhoid (n = 112, 33.2%) and hepatitis A (n = 84, 24.9%) were the most common vaccinations administered to older travellers at the clinic.

    Conclusions: This study provides an insight into the demographics, travel characteristics, and medical profile of elderly travellers seeking advice at a large travel clinic in Ireland. A wide range of travel destinations, diseases and medication use was reported among this group of travellers, which may enable travel medicine physicians to provide more tailored advice and to more appropriately counsel older travellers.

    Matched MeSH terms: Hepatitis A
  12. Ahmad F, Hamzah NA, Mustaffa N, Gan SH
    World J Gastroenterol, 2011 Sep 28;17(36):4130-4.
    PMID: 22039329 DOI: 10.3748/wjg.v17.i36.4130
    To determine the seroprevalence of anti-hepatitis A virus (HAV) antibodies in patients with chronic liver disease (CLD) and to justify the need for hepatitis A vaccination.
    Matched MeSH terms: Hepatitis A/blood*; Hepatitis A/immunology*; Hepatitis A/epidemiology; Hepatitis A/prevention & control; Hepatitis A Vaccines; Hepatitis A Antibodies/blood*; Hepatitis A Antibodies/immunology
  13. Tan DS, Dimitrakakis M, Zaini Rahman M, Fang R, Collett D, Ooi BG, et al.
    PMID: 3024325
    Icteric patients with clinical and biochemical evidence of liver disease, admitted into various hospitals in Malaysia, were investigated to determine the cause of their infection. Of these patients, 11.0% (16/145) were found positive for IgM anti-HAV (EIA), 4.1% (6/145) for IgM anti-HBc (EIA), 1.0% (1/102) for IgM anti-CMV (ELISA), 17.2% (16/64) for rising titres of leptospiral agglutinin, and none for heterophile antibody of EBV. Hepatitis NANB accounted for 67.9% of cases. The mean serum transaminases (ALT and AST) values in patients with hepatitis A and B were higher (more than 500IU) than in patients with leptospirosis or non-A, non-B hepatitis, whereas serum bilirubin levels were higher in patients with hepatitis A and leptospirosis than in patients with hepatitis B.
    Matched MeSH terms: Hepatitis A/etiology
  14. Wong CPP, Lai CW, Lee KM, Hamid SBA
    Materials (Basel), 2015 Oct 19;8(10):7118-7128.
    PMID: 28793623 DOI: 10.3390/ma8105363
    Textile industries consume large volumes of water for dye processing, leading to undesirable toxic dyes in water bodies. Dyestuffs are harmful to human health and aquatic life, and such illnesses as cholera, dysentery, hepatitis A, and hinder the photosynthetic activity of aquatic plants. To overcome this environmental problem, the advanced oxidation process is a promising technique to mineralize a wide range of dyes in water systems. In this work, reduced graphene oxide (rGO) was prepared via an advanced chemical reduction route, and its photocatalytic activity was tested by photodegrading Reactive Black 5 (RB5) dye in aqueous solution. rGO was synthesized by dispersing the graphite oxide into the water to form a graphene oxide (GO) solution followed by the addition of hydrazine. Graphite oxide was prepared using a modified Hummers' method by using potassium permanganate and concentrated sulphuric acid. The resulted rGO nanoparticles were characterized using ultraviolet-visible spectrophotometry (UV-Vis), X-ray powder diffraction (XRD), Raman, and Scanning Electron Microscopy (SEM) to further investigate their chemical properties. A characteristic peak of rGO-48 h (275 cm-1) was observed in the UV spectrum. Further, the appearance of a broad peak (002), centred at 2θ = 24.1°, in XRD showing that graphene oxide was reduced to rGO. Based on our results, it was found that the resulted rGO-48 h nanoparticles achieved 49% photodecolorization of RB5 under UV irradiation at pH 3 in 60 min. This was attributed to the high and efficient electron transport behaviors of rGO between aromatic regions of rGO and RB5 molecules.
    Matched MeSH terms: Hepatitis A
  15. Burke DS, Heisey GB
    Am J Trop Med Hyg, 1984 Sep;33(5):940-4.
    PMID: 6486304
    Serum samples were obtained within 3 days of capture from 106 cynomolgus monkeys (Macaca fascicularis) in peninsular Malaysia. Fifty-two monkeys were trapped on the fringes of palm oil estates and 54 in dense primary jungle. Sera were tested for antibodies to hepatitis A virus (HAV) with a commercial radioimmunoassay. Twenty-four animals had detectable serum anti-HAV activity (6 of 52 from palm oil estate sites and 18 of 54 from primary jungle sites). Among monkeys at both sites, antibody prevalence was strongly correlated with animal weight: overall only four of 69 monkeys (6%) weighing less than 2.0 kg had serum anti-HAV antibodies, while 14 of 29 (48%) weighing 2.0 to 3.9 kg, and 6 of 8 (75%) weighing 4.0 kg or more, had serum anti-HAV antibodies. These data suggest that wild cynomolgus monkeys in Malaysian jungles become infected with HAV or an HAV-like virus at a rate comparable to that of humans in the same region, and raise the possibility of a sylvatic cycle for HAV.
    Matched MeSH terms: Hepatitis A Antibodies
  16. Ahmad F, Che Hamzah NA, Mustaffa N, Hua GS
    Hepatogastroenterology, 2011 07 15;58(110-111):1725-9.
    PMID: 21940338 DOI: 10.5754/hge11107
    BACKGROUND/AIMS: CYP3A4 is the major cytochrome in humans which shows reduced activity in chronic liver disease as well as in hepatic cirrhosis. The detection of this polymorphism may give an indication on the prognosis of patients having chronic viral hepatitis with superimposed hepatitis A infection. The aim of this study is to correlate the seroprevalence of anti-HAV antibodies in chronic liver disease patients having CYP3A4*18 polymorphisms.

    METHODOLOGY: This is a prospective study where patients (n=119) blood was tested for anti-HAVIgG and CYP3A4*18 polymorphism.

    RESULTS: The overall anti-HAV seroprevalence was 88.2%. The etiology of CLD was hepatitis B in 96 patients (80.7%) and hepatitis C in 23 patients (19.3%). There was a significant increase in the age of the prevalence of this disease after 30 years of age (p=0.008). CYP3A4*18 polymorphism was detected in 3 (2.5%) of the patients with chronic liver disease. However, there was no significant association between CP3A4*18 mutation and anti-HAV serology.

    CONCLUSIONS: Age was the most important factor in determining anti-HAV positivity. It is concluded that CYP3A4*18 genetic polymorphism does not play a main role in influencing the seroprevalence of anti-hepatitis A among chronic viral hepatitis B and C liver disease patients.

    Matched MeSH terms: Hepatitis A Antibodies/blood*
  17. Ishak SH, Yaacob LH, Ishak A
    Malays Fam Physician, 2020;15(1):47-49.
    PMID: 32284805
    Dengue is known to cause high morbidity and mortality worldwide. In recent years, there have been increasing cases of dengue fever associated with a rare complication: hemophagocytic syndrome (HPS), which is a dangerous disorder that carries high mortality. It is associated with infections, autoimmune disorders, and malignancies. Prolonged duration of fever and cytopenia together with multi-organ dysfunction out of proportion to the plasma leakage phase should alert clinicians to consider this condition. In this case study, we highlight a 45-year-old woman with underlying diabetes who was admitted due to dengue fever with warning signs. Her conditions deteriorated quickly: she had spontaneous bleeding, evidence of plasma leakage, severe hepatitis, and coagulopathy on the 11th day of illness. With the support of other blood results, such as raised serum ferritin and lactate dehydrogenase, she was diagnosed with severe dengue with hemophagocytosis syndrome. She responded well to intravenous dexamethasone and recovered on the 19th day of illness.
    Matched MeSH terms: Hepatitis A
  18. Rekha Bachhiwal, Rajni Sharma, Pooja Gupta, Jyotsna Shukla
    To ascertain the seroprevalence of enterically transmitted Hepatitis A (HAV) and Hepatitis E (HEV) in cases with acute/subacute hepatitis attending a tertiary care hospital in North West India. Methods: A total of 2936 cases were examined for the presence of current infection with HAV and HEV, determined by demonstration of HAV-IgM and HEV-IgM antibodies using ELISA. Results: Overall seroprevalence for enterically transmitted hepatitis was found to be 24.89%. HAV IgM was present in 7.35% and HEV IgM was present in 17.54% of total cases. HAV infection was predominantly found in pediatric age group while HEV infection was mostly seen among adults. Male preponderance was noted. Enteric hepatitis cases occurred throughout the year. No definitive seasonal pattern was observed. Conclusion: Our data demonstrated high seropositivity of enterically transmitted hepatitis indicating the need for improvement in personal and public hygiene, and development of HEV vaccine
    Matched MeSH terms: Hepatitis A
  19. Meftahuddin, T., Nik Rubiah, N.A.R., Salmiah, M.S., Salbiah, N., Venugopalans, B., Anisah, A.B., et al.
    MyJurnal
    Kajian sero»prevalens dijalankan untuk menentukan prevalens kes Hepatitis A dan ciri-ciri demografinya di Kampung Pangsoon, Kampung Padang dan Kampung Lubuk Kelubi, di Mukim Hulu Langat, pada 15 dan 16 Mac 2003. Sebanyak 1643 sampel telah diperiksa dan didapati 995 kes (60.6%) telah terdeclah tehadap jangkitan Hepatitis A iaitu sebanyak 327 kes di Kampung Pangsoon, 400 kes, Kampung Padang dan 268 kes di Kampung Lubuk Kelubi. Majoriti kes adalah perempuan 545 kes (54 .7%), etnik Melayu 752 kes (75 .6%) , berusia kurang daripada 40 tahun (65%) dengan min umurnya 25 .4 tahun ( SP 1 9) dan tahap pendidikan di peringkat sekolah rendah. Kes di kalangan Orang Asli pula sebanyak 231 kes (23 .2%) . Lebih kurartg 40.3% kes telah bekerja, dengan pendapatan kurang daripada RM1000 sebulan. Majoriti kes mempunyai tandas sempurna 92Z( 95.4% ), sistem air limbah 846( 91 .2%), bekalan air seharrtat 930(96.4%) dan sistem lubang sampah 426( 44.6%) . Terdapat perbezaan yang bererti (p
    Matched MeSH terms: Hepatitis A
  20. Jasmine YS, Lee SL, Kan FK
    Med J Malaysia, 2017 02;72(1):62-64.
    PMID: 28255145
    Haemophagocytic lymphohistiocytosis (HLH) is a potentially fatal disorder resulting from uncontrolled hyperinflammatory response. There had been increase in cases of one of the secondary form of HLH, i.e., infectionassociated haemophagocytic syndrome (IAHS) in severe dengue in recent years. However, the condition remains under diagnosed due to lack of awareness compounded by the lack of validated diagnostic criteria. Severe hepatitis with prolonged cytopenias, severe hyperferritinemia, hypofibrinogenemia and persistent fever were evident in all four cases reported. All the subjects survived with supportive care and adjuvant steroid therapy. Prospective controlled studies are needed to develop diagnostic criteria and management protocol for IAHS in severe dengue.
    Matched MeSH terms: Hepatitis A
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