Thrombocytopenia and Platelets Transfusion in Dengue Fever

Abstract

platelets transfusion in patients with dengue fever in our community hospitals. 
Place and duration of study: This study was done from 1st, September 2010 to 15th, November 2010 in three 
different hospitals, two were urban and one was rural and all three were tertiary care hospitals. 
Materials and methods: Our study was based on 200 patients who were serologically confirmed cases for Dengue 
fever (IgM +ive) and had symptoms and signs of dengue fever for more than four to seven days at the time of 
admission. Clinical data reports of hematological investigations, platelets requirements, and data obtained from daily 
follow up, were analyzed.  
Results: There were 200 serologically confirmed Dengue fever patients, among them 176 were males, 24 females, 
183 patients were urban and 17 were rural patients. Thrombocytopenia was found in 174 (87%) on the day of 
admission. Among them 48 (24%) patients had platelets count in between 20,000 to 40,000/cumm, 46 (23%) had 
platelets count <20,000/cumm, and 4 (2%) had platelets count <10,000/cumm.  Patients having platelets count < 
20,000/cumm all have hemorrhage manifestations. Out of 48 (24%) patients having platelets count in between 
20,000 to 40,000/cumm, 21(43%) had hemorrhagic manifestations. 98(49%) patients were given platelets 
transfusion. None of these patients got platelets transfusion with platelets count above 40,000/cumm. 27 patients 
received platelets therapy inappropriately (platelets count < 40,000/cumm with no hemorrhagic manifestations. 
There was only 2 mortality in these patients.                       
Conclusion: Our study suggests that bleeding occurs more often in patients with severe thrombocytopenia (platelets 
count <20,000/cumm) and these patients need urgent platelets transfusion. Patients having platelets count in between 
20,000-40,000/cumm are at moderate risk and these patients require platelets transfusion if they have hemorrhagic 
manifestation. Platelets count above 40,000/cumm are at low risk and no need of platelets transfusion in these 
patients, only these patients need careful monitoring.