Dengue illness: clinical features and pathogenesis.

The incidence and geographical distribution of dengue has gradually increased during the past decade. This review is an update on dengue virus infections, based on our clinical and laboratory experiences in the Philippines and on other relevant literature. The differential diagnosis of this disease is discussed, especially for use by clinicians where dengue is not endemic. The complex pathogenesis of thrombocytopenia and increased vascular permeability in dengue illness is also discussed. Our recent data suggest that platelet-associated immunoglobulins involving anti-dengue virus activity play a pivotal role in the development of dengue hemorrhagic fever (DHF), as well as thrombocytopenia in secondary dengue virus infections. Further elucidation is needed on the involvement of platelet-associated immunoglobulins on the molecular mechanisms of thrombocytopenia and the increased vascular permeability.