Platelet Indices as a Prognostic Marker in Dengue Fever Cases and number of Days to Improvement

Background: Platelet indices including mean platelet volume (MPV), platelet volume distribution width (PDW), plateletcrit (PCT) and platelet large cell ratio (PLCR), these indices can be measured by an inexpensive and readily available routine blood count and may be useful as a prognostic marker in patients with sepsis Methods: This study was planned to establish platelet indices as a prognostic marker in comparison with APACHE II and SAPS 3 score in severe sepsis patients admitted in Medical Intensive Care Unit under Department of Medicine, Jawahar Lal Nehru Medical College & Hospital, Ajmer. Results: In our study, higher Mean Platelet Volume(MPV) on day 7 was associated with higher APACHE II score, and this difference was statistically significant (p value-0.001). Also, higher Mean Platelet Volume (MPV) on day 7 was associated with higher SAPS III score, and this difference was statistically significant (p value-0.01). Conclusion: In developing countries like India platelet indices (specially MPV and PDW) measured on admission and subsequently can be used as prognostic markers in severe sepsis in emergency and critical care setup. Keywords: MPV, Sepsis, APACHE II, SAPS 3

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Correlation between serum ferritin level and severity of dengue fever in a tertiary care center: an observational study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20212244 ◽

2021 ◽

Vol 9 (6) ◽

pp. 1735

Author(s):

Akash R. Murmu ◽

Mubarak R.

Keyword(s):

Dengue Fever ◽

Prognostic Marker ◽

Serum Ferritin ◽

Confidence Limit ◽

Ferritin Level ◽

Care Center ◽

Tertiary Care ◽

Area Under The Curve ◽

Warning Signs ◽

Severe Dengue

Background: Serum ferritin is an acute phase protein and elevated levels of ferritin have been associated with the pathogenesis of many inflammatory infectious viral diseases. Dengue is a mosquito-borne tropical infection that caused by the dengue virus. TNFα and interleukin 1α, another proinflammatory cytokine, transcriptionally induce the H-chain of ferritin. Therefore, serum ferritin can be used as a prognostic marker for dengue severity.Methods: This is a case control study conducted between July 2017 to December 2018.Results: On the 3rd day of fever, the median values of serum ferritin in dengue, fever without warning signs, with warning signs, and severe dengue were 513.5 ng/ml, 1002 ng/ml and 2352.4 ng/ml respectively. On the 7th day of fever, the median values were 474 ng/ml, 900 ng/ml, and 2949 ng/ml respectively. Serum ferritin 1247 ng/ml on day 3 has a sensitivity of 96.4% and specificity of 91% for prediction of severity. Area under the curve for serum ferritin on day 3 was 0.963 (95% confidence limit: 0.934-0.991). Serum ferritin 1050 ng/ml on day 7 has a sensitivity of 98.2 % and specificity of 93% for prediction of severity. Area under the curve for serum ferritin on day 7 was 0.977 (95% confidence limit: 0.957-0.998).Conclusions: Elevation of serum ferritin was significantly seen in those with severe dengue. Serum ferritin can be used as a prognostic marker for dengue severity. Day 3 serum ferritin can be used as a prognostic marker for dengue severity.

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A Study to Find out the Relationship between Various Platelet Indices and Morbidity Profile of Dengue Fever in Pediatric Patients on Admission in Western Rajasthan, India

Pediatric Infectious Disease ◽

10.5005/jp-journals-10081-1252 ◽

2020 ◽

Vol 2 (2) ◽

pp. 43-50

Author(s):

Mohan Makwana ◽

Sangeeta Kumari ◽

Harish K Mourya ◽

Ramavtar Mitharwal ◽

Shivji Ram

Keyword(s):

Dengue Fever ◽

Pediatric Patients ◽

Platelet Indices ◽

The Relationship

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Role of Novel Platelet Indices in Patients of Dengue Fever

International Journal of Contemporary Pathology ◽

10.5958/2395-1184.2019.00029.9 ◽

2019 ◽

Vol 5 (2) ◽

pp. 42

Author(s):

Swati Singh ◽

Mayurika S Tyagi

Keyword(s):

Dengue Fever ◽

Platelet Indices

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To study the clinical profile of dengue fever and to evolve a prognostic marker based on hematological parameters for severe dengue

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20170705 ◽

2017 ◽

Vol 4 (2) ◽

pp. 538

Author(s):

Shobhana Sivathanu ◽

Kumar Manickam ◽

Sowmya Sampath ◽

Poornima Nagaraj ◽

Sathish Kumar Sunder Kumar ◽

...

Keyword(s):

Detailed Analysis ◽

Dengue Fever ◽

Prognostic Marker ◽

Early Recognition ◽

Hematological Parameters ◽

Inverse Correlation ◽

Clinical Findings ◽

Severe Dengue ◽

Simultaneous Increase ◽

Hematological Profile

Background: Dengue fever is endemic to most parts of India and the clinical recognition of progression to severe dengue may become difficult in the absence of classical findings. Early recognition of shock or hemorrhage and appropriate management with fluids prevents morbidity/mortality to a great extent. In this study, we attempted to evolve a simple hematological prognostic marker for prediction of severe dengue.Methods: This retrospective descriptive study of 67 children was conducted in the Paediatric Department of a Government Medical College. The case records of all the patients with a diagnosis of dengue fever and Severe Dengue were analysed using a preset proforma. Besides the demographic and clinical findings a detailed analysis and comparison of hematological profile was done between cases of dengue fever and severe dengue. The data obtained was analysed statistically in order to arrive at a hematological marker to predict severe dengue. Results: Study population consisted of 67 children with 44 children with dengue fever,12 with DSS and 11 cases with DHF. Detailed analysis of hematological profile of severe dengue showed striking neutrophilia and monocytosis besides thrombocytopenia. Neutrophilia was seen in 78% and monocytosis was prevalent in 91% of cases of severe dengue. Monocytosis with thrombocytopenia was consistently seen during shock/hemorrhage. During recovery the fall of monocytes was accompanied by simultaneous increase in platelets in this group. This inverse relation was found to be statistically significant (p <0.05) Such a significant inverse correlation was not seen in dengue fever group (p >0.05).Conclusions: Monocytosis and neutophilia are consistent features of dengue fever. There is an inverse correlation of monocytosis with thrombocytopenia in severe dengue during shock/hemorrhage which recovers on clinical improvement. Thus monocytosis with thrombocytopenia can be used as a prognostic marker to predict severe dengue.

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Platelet indices evaluation in patients with dengue fever

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20182287 ◽

2018 ◽

Vol 6 (6) ◽

pp. 2054 ◽

Cited By ~ 4

Author(s):

Payal Mukker ◽

Smitha Kiran

Keyword(s):

Platelet Count ◽

Dengue Fever ◽

Mean Platelet Volume ◽

Dengue Infection ◽

P Value ◽

Platelet Distribution Width ◽

Platelet Volume ◽

Distribution Width ◽

Platelet Indices ◽

Significant Difference

Background: Platelet indices (PIs)-Platecrit, mean platelet volume (MPV) and platelet distribution width (PDW)-are a group of platelet parameters obtained as a part of complete blood count using automated hematology analyzers. Evidence suggests that PIs may have diagnostic and prognostic value in febrile thrombocytopenia. This study aims to understand the profile of PIs in dengue fever. Aims and objectives was to study the platelet indices in patients with dengue fever.Methods: The present study is a retrospective observational study conducted in a tertiary hospital in Kerala. Platelet count, mean platelet volume (MPV), platecrit and Platelet distribution width (PDW) along with routine blood parameters hemoglobin(Hb), hematocrit, WBC, Platelet count, serum bilirubin, liver enzymes (AST, ALT) of 123 patients were collected. These 123 patients were grouped into three according to the platelet count (<20000,20000-100000, >100000). All the test results are available in hospital database. This was accessed using inpatient numbers obtained from medical records department of our institution. All analysis was done using free to use software R and values were rounded off to the nearest decimal point. Non normally distributed parameters were expressed as median (IQR). Parameters which did not follow normal distribution were analyzed with Kruskall Wallis test and the values are expressed as mean (SD) and a p value <0.05 was considered statistically significant.Results: Platelet indices PDW (57±13.8 vs. 55.4±6.9, p value 0.001) and MPV (9.2±0.09 vs. 13.8±1.3fL, p value <0.001) values were significantly altered in dengue fever with platelet counts below 20,000 compared to platelet count more than one lakh group. Similarly, the Platelet index (MPVxPDW\PLCxPCT), MPV\PLC, MPV\Platecrit, PDW\PLC and PDW\Platecrit ratio showed statistically significant difference between the different platelet groups.Conclusions: Platelet indices are useful parameters in dengue infection. Other than platelet count, PDW, MPV, platecrit are useful to monitor dengue fever.

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