Clinical and laborator features of measles in adults

Abstract

Measles continues to cause periodic epidemic outbreaks at the present stage, affecting not only children but also the adult population, with the development of various complications, particularly in individuals with comorbid conditions. This necessitates a high level of awareness among healthcare professionals regarding this nosology and further scientific investigation in this field. Aim : To provide a clinical-laboratory characterization of measles in adults and endothelial dysfunction . Methods: A prospective study was conducted including 278 (100%) patients aged over 18 years diagnosed with measles and hospitalized in the Infectious Diseases Department of the multidisciplinary clinic of Tashkent State Medical University between March 2022 and December 2024. The presence of immunosuppression in this patient cohort was established, manifested by transient leukopenia in 62.9% of cases, lymphopenia in 47.5%, and thrombocytopenia in 45.3%. Results : In adults, measles at the present stage was characterized not only by classical clinical manifestations but also by atypical features, including the absence of typical stage progression in 16.5% of patients. Gastrointestinal complications, primarily diarrhea, were observed in 37.8% of patients, leading to dehydration. Hepatomegaly was detected in 38.1% of cases and was associated with cytolytic syndrome. A statistically significant elevation of vascular endothelial growth factor A (VEGF-A) (423.6 ± 37.6 pg/mL) and Creactive protein (CRP) levels (62.7 ± 2.9 mg/L) was observed in severe measles compared to moderate disease (276.4 ± 20.3 pg/mL and 48.3 ± 3.1 mg/L, respectively), indicating pronounced endothelial dysfunction. A correlation was identified between increased interleukin-1 (IL-1) levels and elevated CRP and VEGF-A concentrations, which predisposed to the development of pneumonia in 82 (29.5%) patients. Among these, 2.7% demonstrated elevated procalcitonin levels, suggesting a bacterial etiology of pneumonia. Conclusion : These findings indicate that marked endothelial dysfunction with the development of pathological angiogenesis represents one of the key pathogenetic mechanisms underlying pneumonia formation in adult patients with measles.