Serial Changes in Platelets and Outcomes in Dengue

ABSTRACT

Introduction: With marked growth of the population, rapidurbanization, inappropriate sanitisation and proliferatingtrend of mosquitoes, there is substantial increase in dengueinfections. The fatality rate due to dengue shock syndrome(DSS) can be brought down to as low as <0.2% with carefulmanagement. Understanding the factors which are responsiblefor progression of the disease to the severe stage and death isessential in determining the triage and management steps.Material and methods: All patients suspected to haveprobable dengue / probable dengue fever with warning signswere admitted in government hospital attached to KasturbaMedical College, Mangalore and were given an option ofenrolment in the study. After obtaining informed consent,all potentially eligible patients were screened for enrolment.All necessary blood samples needed to confirm dengue feverand other causes of fever were drawn on the first day. Plateletcounts were done every day till they reach stable levels or tilldischarge.Results: Out of 105 cases (Dengue Fever withoutcomplications), platelet counts (median values) were taken asa parameter. It was observed that the platelet counts are at alowest level on day 2 and day 3 and later on day 4 and day5 it improved. Friedman’s test value = 228.612 and p value<0.001 which was highly significant.Discussion: Thrombocytopenia is a distinctive feature ofdengue and it has been described that its intensity correlateswith the degree of viremia and with the magnitude of theimmune response. It has been suggested that a progressivedecrease in platelets may anticipate the severe form of dengue.