Platelet indices and severity of dengue infection in children

INTRODUCTION: Background: Dengue is becoming endemic in India. Reported case-fatality rate in India is 3-5%.Thrombocytopenia is the most common finding. Platelet indices are gaining importance in the illness.

Aims: To study the platelet indices in children with dengue infection and to note their relationship with the severity of disease.
METHODS: Material and Methods: Observational record based study done over 12 months at a medical college hospital in costal Karnataka. Platelet parameters were noted from hospital based data system and compared with severity of disease (Bleeding score, Severity score, Warning signs and Duration of stay).
RESULTS: Out of 125 dengue positive patients studied, 83% had MPV below 9fl, 68% had PDW below 18, 64% had plateletcrit below 0.1%, 57% had platelet count fall below 1lakh during the illness. Plateletcrit showed significant correlation (p-0.001) with decreasing and increasing trends of platelet count and similar relation to severity of disease. Patients had a longer duration of stay (>4days) when platelet counts decreased to less than 1lakh during the illness compared to those with more than 1lakh (73%vs35%). Platelet counts below 1lakh were noted in 85% (37 of 44) of patients with warning signs as compared to 41% (34 of 81) patients without warning signs.
DISCUSSION AND CONCLUSION: Platelet indices are decreased in dengue infection.Decreased platelet count and plateletcrit correlate with severity of infection.