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Original ArticleOpen Access
Adjunctive Corticosteroid Therapy in 149 Grade II (Non-Shock) Adult DHF Patients: An Analysis during January 2008-February 2010
Srichaikul T 
,
Punyagupta S ,
Sorakhunpipitkul L ,
Udomsubpayakul U
,
Punyagupta S ,
Sorakhunpipitkul L ,
Udomsubpayakul U Background: It is well known that immunopathogenesis play an important role in the development of severe complications
in DHF. Since 2006, the authors have experience in giving immunomodulators to save life of many severe complicated adult
DHF patients. This experience stimulates our interest on the benefit of adjunctive corticosteroid therapy in adult grade II DHF
patients.
Objective: To find out whether there are some benefits of giving adjunctive corticosteroid therapy in adult grade II DHF
patients.
Design of the study: Retrospective analysis during January 2008-February 2010.
Material and Method: One hundred and forty nine adult grade II DHF patients were admitted at Vichaiyut Hospital. They
were divided into 3 groups according to the different therapy designed by the responsible clinicians. Group 1 consisted of
59 cases who received full dose-short course of intravenous dexamethasone (4 milligram every 6 hours for 2-3 days).
Group 2 consisted of 61 cases who received intermittent 4 milligrams intravenous dexamethasone only at febrile episode and
group 3-29 cases did not received corticosteroid. All the patients were investigated similarly. Age, sex, symptoms and signs
including daily hematologic studies (Hct, Wbc, differential count, platelet count) were recorded. Serum SGOT, SGPT,
bilirubin, alkaline phosphatase and albumin BUN, creatinine were performed on admission and repeated as indicated. The
parameter to measure the benefit of adjunctive corticosteroid included 1) severity of thrombocytopenia, 2) liver impairment,
3) the days of illness as determined by fever and 4) the length of the hospital days.
Results: The clinical severity of all the three groups were quite similar. There was no benefit of using adjunctive corticosteroid
therapy in term of changing the severity of thrombocytopenia and liver impairment. However, the days of illness and the length
of hospital days were shorter at 4.6 days and 3.7 days respectively in the group who received full dose, continuous-short
course of dexamethasone intravenously. This is statistically significant when compared to the other two groups who had the
longer total days of fever at 5.8 days and 6.03 days and the longer length of hospital days at 5.19 days and 4.5 days
respectively (p < 0.05).
Conclusion: Adjunctive corticosteroid by given full dose, continuous short course in grade II adult DHF reduced the
course of illness (days of fever) and the length of hospital days. These findings indicated the benefit of using adjunctive
corticosteroid therapy in grade II adult DHF patients.
Keywords: Adult DHF grade II, Full dose with short course of adjunctive corticosteroid therapy, Reduction of days of fever,
Length of hospital day
in DHF. Since 2006, the authors have experience in giving immunomodulators to save life of many severe complicated adult
DHF patients. This experience stimulates our interest on the benefit of adjunctive corticosteroid therapy in adult grade II DHF
patients.
Objective: To find out whether there are some benefits of giving adjunctive corticosteroid therapy in adult grade II DHF
patients.
Design of the study: Retrospective analysis during January 2008-February 2010.
Material and Method: One hundred and forty nine adult grade II DHF patients were admitted at Vichaiyut Hospital. They
were divided into 3 groups according to the different therapy designed by the responsible clinicians. Group 1 consisted of
59 cases who received full dose-short course of intravenous dexamethasone (4 milligram every 6 hours for 2-3 days).
Group 2 consisted of 61 cases who received intermittent 4 milligrams intravenous dexamethasone only at febrile episode and
group 3-29 cases did not received corticosteroid. All the patients were investigated similarly. Age, sex, symptoms and signs
including daily hematologic studies (Hct, Wbc, differential count, platelet count) were recorded. Serum SGOT, SGPT,
bilirubin, alkaline phosphatase and albumin BUN, creatinine were performed on admission and repeated as indicated. The
parameter to measure the benefit of adjunctive corticosteroid included 1) severity of thrombocytopenia, 2) liver impairment,
3) the days of illness as determined by fever and 4) the length of the hospital days.
Results: The clinical severity of all the three groups were quite similar. There was no benefit of using adjunctive corticosteroid
therapy in term of changing the severity of thrombocytopenia and liver impairment. However, the days of illness and the length
of hospital days were shorter at 4.6 days and 3.7 days respectively in the group who received full dose, continuous-short
course of dexamethasone intravenously. This is statistically significant when compared to the other two groups who had the
longer total days of fever at 5.8 days and 6.03 days and the longer length of hospital days at 5.19 days and 4.5 days
respectively (p < 0.05).
Conclusion: Adjunctive corticosteroid by given full dose, continuous short course in grade II adult DHF reduced the
course of illness (days of fever) and the length of hospital days. These findings indicated the benefit of using adjunctive
corticosteroid therapy in grade II adult DHF patients.
Keywords: Adult DHF grade II, Full dose with short course of adjunctive corticosteroid therapy, Reduction of days of fever,
Length of hospital day
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