Thrombocytopenia and its Relationship with Bleeding Manifestations in Dengue Patients-A Tertiary Care Hospital Experience

Mahtab Shabir; Shazia Nisar; Zobia Urooj; Mohina Sohail; Muhammad Shahid Khan; Danish Hassan Khan

doi:10.51253/pafmj.v72i6.4553

Authors

Mahtab Shabir Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Shazia Nisar National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Zobia Urooj Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Mohina Sohail Avalon University School of Medicine, Willemstad, Curaçao
Muhammad Shahid Khan Heavy Industries Taxila Education City Institute of Medical Sciences, Taxila/National University of Medical Sciences (NUMS) Pakistan
Danish Hassan Khan National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v72i6.4553

Keywords:

Bleeding, Blood platelet count, Dengue hemorrhagic fever, Dengue infection, Thrombocytopenia

Abstract

Objective: To explore the extent of bleeding among three different groups of patients based on their blood platelet count and identify the frequency of specific types of bleeding manifestations among the study groups.

Study Design: Comparative prospective study.

Place and Duration of Study: Pak-Emirates Military Hospital, (PEMH) Rawalpindi Pakistan, from Jul to Dec 2019.

Methodology: One hundred patients hospitalized with dengue fever and platelet count of less than 100,000 per microliter of blood were enrolled in the study. They were divided into three groups based on platelet count, i.e., <20,000 (Group-1), 20,000- 50,000 (Group-2), and >50,000 (Group-3) per microliter of blood and observed for different types of bleeds and were also categorized as no bleed, single-site bleed and multiple-site bleed.

Results: Group comparisons revealed that no patient from Group-1 versus 3(10.3%), patients from Group-2 whereas 11(19.3%) patients from Group-3 experienced single site bleed (p=0.05). In addition, patients belonging to Group-1 experienced significantly more petechiae as compared to Groups 2 and 3 (92.8% vs 65.5% vs 19.2%, p<0.001). Similarly, gum bleeding and purpura were more commonly observed in Group-1 than in two other groups (50% vs 44.8% vs 14.0%, p 0.001; 85.7% vs 44.8% vs 3.5%, p<0.001, respectively).

Conclusion: Bleeding complications among dengue patients has a positive relationship with platelet count, but some specific bleeds, e.g., melena, hematemesis, hemoptysis and per vaginal bleed, cannot be directly correlated with the number of platelets circulating in the blood.