Platelet indices evaluation in patients with dengue fever

Abstract

Background: Platelet indices (PIs)-Platecrit, mean platelet volume (MPV) and platelet distribution width (PDW)-are a group of platelet parameters obtained as a part of complete blood count using automated hematology analyzers. Evidence suggests that PIs may have diagnostic and prognostic value in febrile thrombocytopenia. This study aims to understand the profile of PIs in dengue fever. Aims and objectives was to study the platelet indices in patients with dengue fever.Methods: The present study is a retrospective observational study conducted in a tertiary hospital in Kerala. Platelet count, mean platelet volume (MPV), platecrit and Platelet distribution width (PDW) along with routine blood parameters hemoglobin(Hb), hematocrit, WBC, Platelet count, serum bilirubin, liver enzymes (AST, ALT) of 123 patients were collected. These 123 patients were grouped into three according to the platelet count (<20000,20000-100000, >100000). All the test results are available in hospital database. This was accessed using inpatient numbers obtained from medical records department of our institution. All analysis was done using free to use software R and values were rounded off to the nearest decimal point. Non normally distributed parameters were expressed as median (IQR). Parameters which did not follow normal distribution were analyzed with Kruskall Wallis test and the values are expressed as mean (SD) and a p value <0.05 was considered statistically significant.Results: Platelet indices PDW (57±13.8 vs. 55.4±6.9, p value 0.001) and MPV (9.2±0.09 vs. 13.8±1.3fL, p value <0.001) values were significantly altered in dengue fever with platelet counts below 20,000 compared to platelet count more than one lakh group. Similarly, the Platelet index (MPVxPDW\PLCxPCT), MPV\PLC, MPV\Platecrit, PDW\PLC and PDW\Platecrit ratio showed statistically significant difference between the different platelet groups.Conclusions: Platelet indices are useful parameters in dengue infection. Other than platelet count, PDW, MPV, platecrit are useful to monitor dengue fever.

Study of platelet indices in dengue fever with thrombocytopenia and correlation of immature platelet fraction (IPF) with platelet recovery

“…We can see from table 2, the value of mean MPV increases as the platelets count increases. This is in accordance with the study conducted by Bashir, et al, 2015, Anuradha, et al, 2014, Navya, et al, 2016and Mukker, et al, 2018 They also observed low value of mean platelet volume (MPV) with low platelet count. Navya, et al,2016 in their study group of 100 patients, saw a mean MPV of <9 fl in 72% of patients.…”

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“…The present study showed a significantly low MPV in patients with platelet count below 20,000/cu.mm compared to patients with higher platelet counts. Similar result was found by Mukker P, et al in their retrospective observational study [27]. We found significant fall in MPV on the previous day of the day on which platelet count came below 20,000/cu.mm, thus indicating that the significant fall in platelet count may be predicted by looking at serial MPV.…”

The Utility of Platelet Indices in Predicting Multiorgan Dysfunction in Scrub Typhus

“…In a study by Camara-Lemarroy et al, MPV had 82% sensitivity and 78% and specificity to differentiate bacterial meningitis from tuberculous meningitis [20]. MPV as a utility in dengue has varied with different studies [14]. In Brazil, a higher MPV was found with the first vivax malaria infection and those with symptoms for >3 days [20].…”

“…PDW has been used in the identification of pulmonary tuberculosis and acute cholecystitis and organ failure in acute pancreatitis [25]. Increased PDW was seen in ascitic fluid infection, vivax malaria, dengue, and septic shock [5,9,13,14]. PDW was reduced in deep-seated surgical site infection in orthopaedic patients and children with Gram-positive organism-related urinary tract infection [6,10].…”