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
Mohan Makwana, Harish K Mourya, Ramavtar Mitharwal, Shivji Ram
Citation Information :
Makwana M, Mourya HK, Mitharwal R, Ram S. 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. Pediatr Inf Dis 2020; 2 (2):43-50.
Background: Dengue is a major international public health concern. Various clinical and biochemical parameters are being used to predict severity of this disease. Blood platelets and their indices are one of them. Platelet indices like mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR) have been investigated as prospective platelet activation indicators. Aims and objectives: To find out the relationship between the platelet indices at admission and morbidity profile of dengue patients. Materials and methods: The study was an observational study conducted on patients of pediatric age group in Department of Pediatrics, Dr SN Medical College, Jodhpur, over a period of 1 year. All ELISA (IgM + IgG) positive cases were enrolled in the study. Results: In this study high MPV, high PDW, and high P-LCR were associated with longer duration of hospital stay and longer duration of fluid therapy requirement. These patients required ICU care more frequently, more time to recover from severe thrombocytopenia (TCP), and had deranged SGPT and serum creatinine values, which were commonly seen with high MPV. Shock was more frequently seen with high MPV, and bleeding manifestations were more common with low MPV. Almost 80% patients were admitted with low plateletcrit (PCT), which was associated with longer duration of hospital stay, longer duration of fluid therapy, required ICU care more frequently, required more time to recover from severe TCP, landed up in shock more frequently, and required more blood product transfusion. High MPV, high P-LCR, low PCT, and severe TCP were associated with more frequent positive tourniquet test with a highly significant p value. Bleeding manifestations and neurological symptoms were seen more with low MPV. Conclusion: We observed significant correlation of P-LCR, PDW, and MPV on admission with those morbidity parameters. High MPV, high P-LCR, high PDW, and low PCT were associated with longer duration of hospital stay, fluid therapy requirement, time taken to recover from TCP, frequent requirement of ICU care, and more frequent liver and renal function dysfunctions. They had higher chances of developing dengue shock syndrome.
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