Thrombocytopenia in Dengue Hemorrhagic Fever
Abstract
According to WHO thrombocytopenia is one of the diagnostic criteria of DHF. On the other hand many studies have reported DHF cases without evidence of thrombocytopenia.
One hundred fifty nine DHF out of485 suspected cases were assessed for their platelet counts. Diagnosis of DHF was established based on the WHO criteria, and confirmed by the hemagglutination inhibition test. The platelet counts were done serially and intensively by phase contrast microscope from the first day of hospitalization until the patient's discharge.
In 77 patients thrombocytopenia appeared for the first time during hospitalization. Mild thrombocytopenia appeared in almost all of these cases before thrombocyte count of 100,000 reached. Seventy two patients had shown thrombocytopenia on the day of admission. No thrombocytopenia was found on the second day of illness, the earliest time of the detection of thrombocytopenia was on the Jrri and the latest was on the 8th day of illness. Thrombocytopenia lasted 1-5 days. It is concluded that many DHF diagnosis would have been missed if the thrombocyte investigation had not been done serially and intensively. Mild thrombocytopenia in DHF suspected patients should call attention to do platelet investigation intensively in those cases.
References
2. Swnanno, Widya MS. Dengue Hemorrhagic Fever. Klinik, Diagnosis dan Pengobatan. Bull JDAI Cabang Jakarta 1973; 1: 72-5.
3. Sumarmo, Widya S, Koesno Martoatmodjo. Observations on Hospitalized Patients with Dengue Hemorrhagic Fever. Pediatr lndones 1975; 15: 143-9.
4. Rosyid RA, Nelwan, Sutrisno DS, Teluk Sembodo and Ismangoen
5. Muzief Munir, Tjandra Husada and Mustadjab, I.Dengue Hemorrhagic Fever. Paediatr Indones
1982; 22: 11-22.
6. Sumanno. Clinical Observations on Virologically Confinned Fatal Dengue Infections in Jakarta Indonesia. Bull.WHO. 1983; 61:693-701.
7. Miale JB. Laboratory Medicine Hematology 4th ed. The Mosby Saint Louis (1972).
8. Halstead SB. Antibody, Macrophages, Dengue Virus Infection, Shock an Hemorrhagic. A Pathogenesis Cascade. Ref.infect.Dis (supplement) 1989; 11: 830-9.
9. Wong HB, l..iat AP, da Vellyappan K and Ismael G. Dengue Hemonhagic Fever in Children in Singapore in the 1973 Outbreak I. General Features and Criteria fOf' Shock and Preshock. J Sing Pediatr Soc. 1973; 15: 46-53.
10. Songco RS, Hayes CG, Leus CD and Manoloto COR. Dengue Fever/ Dengue Hemorrhagic Fever in Filipina Children. Clinical Experience during 1983-1984 Epidemic. SEAMED-TROPMED 1987; 18: 284-90.
11. Muzief MWlir and Rampengan TH. Dengue Shock Syndrome. An Evaluation of Clinical Experiences. Paediatr lndones 1984; 24: 254-64.
12. Nathan DG and Oski FA. Hematology of Infancy and Childhood 3"' ed., pp 1380-82 (WB Saunders, Philadelphia 1987).
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Published 2019-01-28
