Dengue and calcium.

Dengue is potentially fatal unless managed appropriately. No specific treatment is available and the mainstay of treatment is fluid management with careful monitoring, organ support, and correction of metabolic derangement. Evidence with regards to the role of calcium homeostasis in dengue is limited. Low blood calcium levels have been demonstrated in dengue infection and hypocalcemia maybe more pronounced in more severe forms. The cause of hypocalcemia is likely to be multifactorial. Calcium has been also implicated in the immuopathogenesis of dengue; however, the precise clinical implications of these interactions are yet not clearly defined. Derangements of calcium homeostasis are likely to be associated with myocardial dysfunction and cardiac arrhythmias observed in dengue as suggested by in vitro studies. Calcium also plays a role in platelet aggregation. Studies evaluating the therapeutic use of calcium in dengue have been underpowered and poorly designed to make any firm recommendations. Further studies are needed to explore the role and usefulness of maintenance of calcium homeostasis in modulating cardiac dysfunction, immunopathogenesis, and platelet abnormalities related to dengue.