Serial Changes in Platelets and Outcomes in Dengue

Abstract

Introduction: With marked growth of the population, rapid urbanization, inappropriate sanitisation and proliferating trend of mosquitoes, there is substantial increase in dengue infections. The fatality rate due to dengue shock syndrome (DSS) can be brought down to as low as <0.2% with careful management. Understanding the factors which are responsible for progression of the disease to the severe stage and death is essential in determining the triage and management steps. Material and methods: All patients suspected to have probable dengue / probable dengue fever with warning signs were admitted in government hospital attached to Kasturba Medical College, Mangalore and were given an option of enrolment in the study. After obtaining informed consent, all potentially eligible patients were screened for enrolment. All necessary blood samples needed to confirm dengue fever and other causes of fever were drawn on the first day. Platelet counts were done every day till they reach stable levels or till discharge. Results: Out of 105 cases (Dengue Fever without complications), platelet counts (median values) were taken as a parameter. It was observed that the platelet counts are at a lowest level on day 2 and day 3 and later on day 4 and day 5 it improved. Friedman's test value = 228.612 and p value <0.001 which was highly significant. Discussion: Thrombocytopenia is a distinctive feature of dengue and it has been described that its intensity correlates with the degree of viremia and with the magnitude of the immune response. It has been suggested that a progressive decrease in platelets may anticipate the severe form of dengue.