Anita Mehta, Abha Pandit


Background and aim: Predicting of bleeding risk in dengue infection with feasible means continues to be important concern. This study evaluates usefulness of basic haematological tests in this respect. Method: This is cross sectional study in pediatric dengue patients categorized as not bleeding; having petechial bleeds and having mucosal bleeds. At the highest measured packed cell volume (PCV) in the patients during hospitalization, bleeding status was noted, simultaneously with platelet and leukocyte counts. Patients were segregated around medians of these parameters to assess relation to bleeding status. Odds ratios were calculated to indicate bleeding risk. Results: Of duely investigated 95 cases, 68 had bleeds, 40 with petechie and 28 with mucosal spots. Median highest PCV was 37.1%, and median platelet and leukocyte counts were respectively 52000/micro litre and 3400/micro litre. Odds ratio of bleeding risk above median PCV values was 2.16 times, that for petechie 2.07 and for mucosal bleeds 2.27 times. Below median platelet counts yielded bleeding risk odds ratios 2.19 times overall, 1.9 for petechie and 3.06 for mucosal bleeds. Leukocyte counts did not appear to be consequential.

Conclusion: Basic laboratory evaluations of PCV and platelet count are found useful to predicting bleeding risk in pediatric dengue infection.


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. World Health Organization Dengue: Guidelines for diagnosis, treatment, prevention and control. Geneva WHO 2009

. Shu PY, Huang JH. Current advances in dengue diagnosis. Clin Diagn Lab Immunol. 2004; 11(4):642-650.

. Carlos CC, Oishi K, Cinco MT, Mapua CA, Inoue S, Cruz DJ, et al. Comparison of clinical features and hematologic abnormalities between dengue fever and dengue hemorrhagic fever among children in the Philippines. Am J Trop Med Hyg. 2005;73(2):435-40

. Martina BE, Koraka P, Osterhaus AD. Dengue virus pathogenesis:an integrated view Clin Microbiol Rev. 2009; 22(4):564-81.

. Balmaseda A, Hammond SN, Pérez MA, Cuadra R, Solano S, Rocha J, Idiaquez W, Harris E. Short report:Assessment of World Health Organization scheme for classification of Dengue severity in Necaragua. Am J Trop Med Hyg. 2005; 73(6):1059-62.

. Souza DG, Fagundes CT, Sousa LP, Amaral FA, Souza RS, Souza AL et al Essential role of platelet activating factor receptor in the pathogenesis of Dengue viras infection. Proc Natl Acad Sci U S A. 2009; 106(33):14138-43

. Lin YS, Yeh TM, Lin CF, Wan SW, Chuang YC, Hsu TKet al.Molecular mimicry between virus and host and its implications for dengue disease pathogenesis. Exp Biol Med (Maywood). 2011; 236(5):515-23

. Assunção-Miranda I, Amaral FA, Bozza FA, Fagundes CT, Sousa LP, Souza DG, Pacheco P et al Contribution of macrophage migration inhibitory factor to the pathogenesis of dengue virus infection. FASEB J. 2010; 24(1):218-28.

. Gibbons RV, Vaughn DW. Dengue: an escalating problem. BMJ. 2002; 324(7353):1563-6.

. Chen MC, Lin CF, Lei HY, Lin SC, Liu HS, Yeh TM, Anderson R, Lin YS. Deletion of C-terminal region of dengue virus nonstructural protein 1(NS1) abolishes anti(NS1) mediated platelet dysfunction and bleeding tendancy. J Immunol. 2009; 183(3):1797-803

. Krishnamurti C, Peat RA, Cutting MA, Rothwell SW. Platelet adhesion to dengue-2 virus infected endothelial cells. Am J Trop Med Hyg. 2002; 66(4):435-41.

. Kittigul L, Pitakarnjanakul P, Sujirarat D, Siripanichgon K. The differences of clinical menefestations and laboratory findings in children and adults with dengue virus infection. J Clin Virol. 2007; 39(2):76-81

. Gregory CJ, Santiago LM, Argüello DF, Hunsperger E, Tomashek KM. Clinical and laboratory features that differentiate dengue from other febrile illnesses in an endemic area Puerto Rico 2007-2008. Am J Trop Med Hyg. 2010; 82(5):922-9.

. Gupta V, Yadav TP, Pandey RM, Singh A, Gupta M, Kanaujiya P, Sharma A, Dewan V. Risk factors of dengue shock syndrome in children. J Trop Pediatr. 2011; 57(6):451-6.


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