Pattern Analysis of Thrombocytopenia in Dengue versus Non-Dengue Patients

Abstract

Introduction: Dengue fever is one of the most prevalent and fastest spreading mosquito-borne arboviral infection occurring in tropical and sub-tropical regions around the world and leads to explosive outbreaks in urban areas influenced strongly by rainfall and temperature. Aim: Evaluation of extent of thrombocytopenia in dengue positive patients. To compare the pattern of fall and rise in platelet counts for five consecutive days in dengue positive cases and dengue negative controls. Materials and Methods: The present study was a case control study undertaken in a tertiary care centre in Mangalore for three months. A total of 149 cases of thrombocytopenia were studied, out of which 85 were laboratory confirmed cases of dengue. Dengue cases with platelet value >1 lac/µL and < 1 lac/µL were noted. The remaining 64 cases of thrombocytopenia (platelet< 1 lac/µL) with dengue negative serology tests were used as controls. The pattern of fall and rise in platelet counts in five consecutive days in both dengue positive cases and dengue negative controls were studied. Result: Among the 64 dengue positive thrombocytopenia cases, 34(40%) cases had mild thrombocytopenia (platelet count 51000/µL -1 lac/µL), 25 (29.41%) cases had moderate (20000/µL -50000/µL) thrombocytopenia and 5 cases(5.88%) had severe (< 20000/µL) thrombocytopenia. Among the dengue negative thrombocytopenia control group 39(60.93%) cases had mild thrombocytopenia, 16(25%) patients had moderate thrombocytopenia and 9 (14.06%) patients had severe thrombocytopenia. A graph is plotted comparing the median platelet values in five consecutive days in dengue positive thrombocytopenia cases and dengue negative thrombocytopenia controls. Z-test was used to compare the difference in the platelet values among case and control groups and to know the statistical significance between them. Conclusion: The median platelet values on consecutive days in dengue positive cases shows a gradual increase in platelet values around the time of recovery i.e. 5th day, even without platelet transfusion. In dengue negative thrombocytopenia graph, the median values of platelet count on consecutive days is almost constant till 5th day without any marked rise.

Keywords

• aedesegypti
• arboviral infection
• platelet counts
• transfusion