Steroid responsive prolonged thrombocytopenia in dengue

Bhalla, Ashish; Bagga, Rashmi; Lk, Dhaliwal; Sharma, Ratti Ram; Varma, Subhash

doi:10.4103/0019-5359.94406

Cited by 7 publications

(5 citation statements)

References 3 publications

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“…Thrombocytopenia was a consistent feature of DF and almost always found in DHF/SS, and usually, platelet count normalizes by day 10 of fever. Very few cases were reported worldwide having prolonged thrombocytopenia beyond day 10 . Dengue HLH should be suspected in any patient with persistent thrombocytopenia who has a history of fever in recent past.…”

Section: Discussionmentioning

confidence: 99%

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Dengue hemophagocytic syndrome: A systematic review and meta‐analysis on epidemiology, clinical signs, outcomes, and risk factors

Giang

Banno

Minh

et al. 2018

Reviews in Medical Virology

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We systematically searched and meta-analyzed the epidemiological characteristics, frequency of clinical signs, and outcomes of dengue-associated hemophagocytic lymphohistiocytosis. Ten electronic databases were searched systematically plus manual search of reference lists to identify relevant articles published until May 2017. The highest number of reported cases were from South-East Asia region (62 cases), followed by Western Pacific region (20 cases), and America (31 cases). The term "dengue hemorrhagic fever" predominated in studies that used the World Health Organization 1997 definition (59.7%), whereas "severe dengue" predominated in studies using the World Health Organization 2009 definition (76.8%). Among 122 cases, fever, splenomegaly, hepatomegaly, anemia, thrombocytopenia, and serum ferritin ≥500 μg/L were likely to report by articles representing by large sample size. The pooled proportion of these findings were as follows: fever 97.2%, hepatomegaly 70.2%, splenomegaly 78.4%, thrombocytopenia 90.1%, anemia 76.0%, and serum ferritin ≥500 μg/L 97.1%. This study highlighted a high case fatality rate (14.6%) and co-infection among dengue hemophagocytic lymphohistiocytosis patients. We suggest that long fever duration, persistent thrombocytopenia, elevated serum ferritin, and lactate dehydrogenase levels could be good diagnostic indicators for dengue-associated hemophagocytic syndrome. Bone marrow aspiration could be used as one criterion for diagnosis but is not obligatory. Further research is needed to examine the possible risk difference for development of hemophagocytic syndrome and to explore potential relationships between specific dengue classifications and dengue-associated hemophagocytic syndrome.

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Section: Discussionmentioning

confidence: 99%

“…Very few cases were reported worldwide having prolonged thrombocytopenia beyond day 10. 44,46 Dengue HLH should be suspected in any patient with persistent thrombocytopenia who has a history of fever in recent past.…”

Section: Discussionmentioning

confidence: 99%

Dengue hemophagocytic syndrome: A systematic review and meta‐analysis on epidemiology, clinical signs, outcomes, and risk factors

Giang

Banno

Minh

et al. 2018

Reviews in Medical Virology

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“…17 Bhalla et al reported a 34-year-old woman who had persistent thrombocytopenia for more than 10 days with bleeding manifestations and responded well to steroids. 18 Luiz Jose'de Souza et al has reported a 46-year-old woman with a dengue virus infection with prolonged ITP which responded to steroids. 19…”

Section: Discussionmentioning

confidence: 99%

Persistent thrombocytopenia in Dengue Fever is rare but not uncommon - can be treated with steroid successfully

Islam¹,

Akter²,

Chowdhury³

et al. 2021

Bangla J Med

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Fever, skin rash, thrombocytopenia and bleeding are common manifestation of dengue fever (DF). Thrombocytopenia usually gets better and platelet count normalizes by day 10 of fever. Chronic thrombocytopenia is not a feature of dengue fever. Proposed mechanisms behind thrombocytopenia are many. Direct platelet destruction by dengue virus, immune-mediated platelet destruction and evenmegakaryocytic immune injury are proposed as underlying mechanisms. We are reporting a case of a 43 year old female who presented in dengue season in 2019 with fever and bleeding and wasdiagnosed as a case of dengue haemorrhagic fever. She had persistent thrombocytopenia which neededto be treated on the lines of immune thrombocytopenia and responded to steroids. Other causes of thrombocytopenia were ruled out. Bangladesh J Medicine January 2021; 32(1) : 62-64

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“…Unfortunately, as it may hold true for most diseases, a high index of suspicion and a search for certain clinical indicators may be the only approach to diagnosing such a predicament. To the best of our knowledge, only a few authors in the past have reported an association with dengue and ITP, all having a dramatic response with corticosteroids [13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Immune Thrombocytopenic Purpura During a Dengue Outbreak: A Dynamic Masquerader

Kodiatte¹,

Kumar²

2019

IJCR

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In this age of enhanced diagnostics and improved turnaround time, immune thrombocytopenic purpura (ITP), a disease primarily diagnosed by exclusion, is expected to be straightforward to diagnose. However, during a full-fledged dengue outbreak, the health-care system can be overwhelmed, and as a result, ITP can be underdiagnosed. The clinician should be aware of the various imitations that ITP can present with. Various clinical indicators have to be kept in mind while dealing with such an outbreak to avoid unnecessary health-care expenditure and prolonged hospital stays. In this case series, we present two patients diagnosed to have ITP during the dengue outbreak, each unique in its presentation and course, demonstrating the multiple patterns ITP can present itself.

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Steroid responsive prolonged thrombocytopenia in dengue

Cited by 7 publications

References 3 publications

Dengue hemophagocytic syndrome: A systematic review and meta‐analysis on epidemiology, clinical signs, outcomes, and risk factors

Dengue hemophagocytic syndrome: A systematic review and meta‐analysis on epidemiology, clinical signs, outcomes, and risk factors

Persistent thrombocytopenia in Dengue Fever is rare but not uncommon - can be treated with steroid successfully

Immune Thrombocytopenic Purpura During a Dengue Outbreak: A Dynamic Masquerader

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