Role of Platelet Indices in Patients With Thrombocytopenia in Serologically Positive Dengue Patients
Background: Dengue fever (DENV) is one of the most rapidly spreading mosquito-borne viral diseases in the world. An estimated 50 million infections per year occur across approximately 100 countries. 30 fold increased incidence and geographic expansion with potential for further spread has been noted. Platelet count is a predictive prognostic factor of severe dengue. Besides platelet count, automation in haematology has provided newer parameters i.e., platelet indices like Plateletcrit (PCT), Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet Large Cell Count (P-LCC) and Platelet Large Cell Ratio (P-LCR). This study aims to analyse the relationship of platelet indices in thrombocytopenic dengue patients thus helping clinicians by providing quick and reliable diagnostic and prognostic findings. Objective: To analyse the relationship of platelet indices in thrombocytopenic dengue patients. Materials and Methods: A cross sectional, observational study at a tertiary health care centre over a period of 2 years including 113 dengue cases presenting with thrombocytopenia. Thrombocytopenia was graded according to platelet count per ml as Grade 1 (75,000-1,50,000), Grade 2 (50,000-75,000), Grade 3 (25,000-50,000) and Grade 4 (<25,000). Results: In this study of 113 cases, maximum cases (46.9%) were seen in 21-30 year age group followed by 11-20 year age group (15.04%). Least number of cases belonged to 61-70 year age group (2.65%). 81 were males and 32 were females. Most common presenting symptom was headache (58.40%). The other symptoms were body ache (46.90%), arthralgia (27.43%) and maculopapular rash(32.74%). A total 50 cases (44.25%) shows grade 2 thrombocytopenia, 31 cases (27.43%) show grade 3 thrombocytopenia and 13 cases (11.50%) show grade 4 . The Mean values of the Platelet indices were as follows: Mean Platelet Volume (MPV)= 6.43 fL which was less than normal limit (8-11 fL); Platelet Distribution Width (PDW) = 19.67% which was greater than normal range of 11-18%; Plateletcrit (PCT) = 0.05which was near the lower limit of laboratory reference range; Platelet Large Cell Count (PLCC) = 35.68 x 103/ul which was lower than normal range 44-140 x 103/ul; Platelet Large Cell Ratio (PLCR) = 32.35 % which was within laboratory reference range of 18-50%. Conclusion: In conclusion, significant differences i.e., Low platelet count, MPV, PCT, PLCC and high PDW, observed in dengue fever with thrombocytopenia can be used as a diagnostic aid with considerable sensitivity for dengue fever in endemic areas.