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Dengue -IgM (CLIA)
Bacterial/ Viral
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No Fasting Required
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Detects Immunoglobulin M (IgM) antibodies produced in response to a recent dengue virus infection
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Dengue - IgM (CLIA) Test Information Guide
- Why is it done?
- This test detects IgM antibodies against dengue virus, which are produced during acute or recent dengue infection
- Ordered to confirm acute dengue fever in patients presenting with fever, headache, myalgia, arthralgia, and rash
- Performed when patients have symptoms consistent with dengue within 3-5 days of fever onset
- Useful in endemic regions or for patients with travel history to dengue-affected areas
- Helps differentiate dengue from other viral illnesses presenting with similar symptoms
- Primary diagnostic method during the early acute phase of dengue infection
- Normal Range
- Normal/Negative Result: Less than 0.9 Index or Non-Reactive Indicates no recent dengue virus infection
- Borderline/Equivocal Result: 0.9 to 1.0 Index Result is uncertain; repeat testing recommended in 1-2 weeks
- Positive Result: Greater than 1.0 Index or Reactive Consistent with acute dengue virus infection
- Units: Index value or qualitative (Reactive/Non-Reactive) CLIA methodology uses chemiluminescent immunoassay
- IgM antibodies typically appear 3-5 days after symptom onset and peak at 1-2 weeks
- Interpretation
- Positive IgM Result: Indicates acute dengue infection (current or very recent) Patient should be monitored for dengue fever or potentially severe dengue
- Negative IgM Result: Likely does not have acute dengue; however, if tested too early (<3 days), may represent false negative Consider repeat testing if clinical suspicion remains high
- Borderline Result: Requires clinical correlation and repeat testing May represent early infection, late infection, or non-specific reactivity
- Timing Considerations: IgM peaks during first 1-2 weeks, then declines over 3-4 months IgM persistence can be seen in secondary infections or certain chronic infections
- Cross-Reactivity: IgM may cross-react with other flaviviruses (Zika, West Nile, Yellow Fever) Clinical context and travel history are important for interpretation
- Secondary vs Primary Infection: In secondary infections, IgM titers are typically lower and appear later IgG testing combined with IgM helps differentiate primary from secondary infection
- Clinical symptoms and laboratory findings should be correlated for accurate diagnosis
- Associated Organs
- Primary Systems Involved:
- Circulatory/Vascular system - virus affects endothelial cells causing plasma leakage
- Lymphoid tissues - where virus replicates and immune response is initiated
- Liver - commonly involved, can lead to hepatitis with elevated transaminases
- Hematologic system - thrombocytopenia and hemoconcentration are common
- Associated Diseases and Conditions:
- Dengue Fever - acute febrile illness with fever, headache, myalgia, arthralgia, and rash
- Dengue Hemorrhagic Fever (DHF) - severe form with hemorrhagic manifestations and plasma leakage
- Dengue Shock Syndrome (DSS) - life-threatening complication with circulatory collapse
- Secondary dengue infection - typically more severe than primary infection
- Potential Complications:
- Severe bleeding and coagulopathy - risk of fatal hemorrhage
- Shock and multi-organ failure - from plasma leakage and circulatory compromise
- Acute liver failure - in severe cases with severe hepatitis
- Encephalitis and neurological complications - including guillain-barré syndrome
- Renal injury - acute kidney injury in severe dengue
- Follow-up Tests
- If Dengue IgM is Positive:
- Dengue IgG serology - to determine if primary or secondary infection
- Dengue RT-PCR - viral nucleic acid detection; most specific early in infection
- Complete Blood Count (CBC) - assess platelet count, hematocrit, for dengue hemorrhagic fever
- Liver Function Tests (LFTs) - AST, ALT to evaluate hepatic involvement
- Coagulation studies - PT/INR, aPTT, fibrinogen in severe cases
- Blood glucose - dengue can cause hypoglycemia in severe cases
- Electrolytes and renal function - to monitor for complications
- If Result is Borderline/Equivocal:
- Repeat Dengue IgM testing in 1-2 weeks to confirm results
- Dengue RT-PCR or Dengue IgG for additional confirmation
- If Result is Negative but High Clinical Suspicion:
- Repeat serology after 3-5 days if tested early in illness
- Dengue RT-PCR for viral detection if still within viremic period
- Consider alternative viral serology (Zika, West Nile) if in endemic regions
- Monitoring for Confirmed Dengue:
- Serial CBC monitoring during critical phase (days 3-7) - watch for falling platelet count
- Daily or every 48-hour monitoring in hospitalized patients for disease progression
- Hematocrit monitoring - more than 20% increase suggests plasma leakage
- Fasting Required?
- Fasting: No
- Fasting is not required for dengue IgM serology; patient can eat and drink normally before test
- Sample Collection:
- Blood sample via venipuncture - typically 3-5 mL serum collected in SST tube
- No specific timing restrictions - can be collected at any time of day
- Medication Considerations:
- No medications need to be held or avoided specifically for this test
- Note: Antiviral medications do not affect IgM test accuracy
- Patient Preparation:
- Stay hydrated - important for patients with dengue fever who may have fever and dehydration
- Bring valid identification and insurance information
- Inform healthcare provider of recent travel to dengue-endemic areas
- Optimal timing: 3-5 days after fever onset for maximum IgM detection
How our test process works!
