Hematological observations as diagnostic markers in dengue hemorrhagic fever--a reappraisal.

ABSTRACT

OBJECTIVE: To determine the utility of certain clinical and hematological parameters as diagnostic markers of dengue hemorrhagic fever (DHF), namely, (i) tourniquet test, (ii) association of bleeding manifestations with the platelet count, and (iii) "cut off" value of hematocrit diagnostic of DHF in Indian population. DESIGN: Prospective study. SETTING: Tertiary care hospital. SUBJECT 304 children of DHF presenting between September 1996 to December 1996. RESULTS: The tourniquet test had a low sensitivity and was positive only in 61/239 (25.5%) cases. There was no statistical difference in the incidence of bleeding manifestations between thrombocytopenic and non-thrombocytopenic individuals highlighting poor association of thrombocytopenia with bleeding manifestations. A "cut off" hematocrit value of 36.3% diagnostic of DHF was estimated by discriminant analysis in Indian population. CONCLUSION: The study highlights tourniquet test as a less sensitive diagnostic marker of DHF, poor association of thrombocytopenia with bleeding manifestations and also defines the hematocrit value diagnostic of DHF in Indian population.