However, although one study reported an association between elevated levels of VEGF and D-dimer [30], another study showed that plasma levels of VEGF and its soluble receptors were not associated with the occurrence of bleeding in patients without plasma leakage, suggesting that bleeding is a complication independent of changes in endothelial barrier function [24], as established by the WHO dengue case classification 2009 [11]. The gene discussed is VEGFA; the disease is dengue disease.