Absolute Neutrophil Count and Thrombocytopenia in Patients ofAcute Dengue Infection

Rafia Behzad; Sehar Khaliq; Rafiq Ahmed Shahid

doi:10.70302/jpsim.v5i1.2408

Original Research

Absolute Neutrophil Count and Thrombocytopenia in Patients ofAcute Dengue Infection

Rafia Behzad¹

Foundation University Medical College, Rawalpindi

Sehar Khaliq¹

Foundation University Medical College, Rawalpindi

Rafiq Ahmed Shahid²

Sharif Medical and Dental College, Lahore

✉ Correspondence: Rafia Behzad Email: rafia.behzad@gmail.com

DOI https://doi.org/10.70302/jpsim.v5i1.2408

Volume: 5, Issue 1 (Women Issue) Pages: 393–397 Published: 28 Feb 2024

Received: 14 Oct 2023 Accepted: 29 Nov 2023 Published Online: 28 Feb 2024

Abstract

Objective

To determine mean Absolute Neutrophil Count and frequency of thrombocytopenia in patients of acute dengue infection.

Methods

This descriptive cross sectional study was done in Hematology Department, Medical and Pediatric wards, Fauji Foundation Hospital, Rawalpindi. A total of 100 patients diagnosed as a case of acute dengue infection based on Indirect ELISA for anti DENV IgM were selected using inclusion and exclusion criteria. Venous blood of 2.5 ml of these patients was collected in CP bottle containing EDTA as anticoagulant. It was analyzed on automated Hematology analyzer Sysmex XT 2000i system. Blood levels of Absolute Neutrophil Count and platelet count were recorded and documented for these patients.

Results

Out of 100 diagnosed patients of acute dengue infection, 81% exhibited thrombocytopenia, while the mean absolute neutrophil count calculated in these patients was 1.96 x 109 /L.

Conclusion

Acute dengue fever is characterized by thrombocytopenia and neutropenia. Therefore, in a patient with signs and symptoms of acute febrile illness, a blood count analysis is imperative in assisting earlier diagnosis of dengue fever.

Keywords

: Acutedengue infection CompleteBloodCount(CBC) AbsoluteNeutrophilCount(ANC) Thrombocytopenia.

How to Cite This Article

Behzad R, Khaliq S, Shahid RA. Absolute Neutrophil Count and Thrombocytopenia in Patients ofAcute Dengue Infection. J Pak Soc Intern Med. 2024;5(1):393–397. doi:10.70302/jpsim.v5i1.2408

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

Ho TS, Wang SM, Lin YS, Liu CC. Clinical and laboratory predictive markers for acute dengue infection. J Biomed Sci.2013;20(1): 75.
Bos S1, Gadea G1, Despres P1. Dengue. A growing threat requiring vaccine development for disease prevention. Pathog Glob Health. 2018;112(6):294-305.
Jameel T, Mehmood K, Mujtaba G, Choudhry N, Afzal N, Paul RF. Changing haematological parameters in dengue viral infections. J Ayub Med Coll Abbottabad. 2012; 24 (1):3-6.
Sabat J1, Subhadra S1, Thakur B1, Panda M1, Panda S1, Pati SS1, Ho LM1, Dixit S1, Rathore SK1, Kar SK2, Dwibedi B3.Molecular and phylogenetic analysis of the dengue strains circulating in Odisha, India.Virusdisease. 2019;30(3):380-6.
Saba S, Khan AUR, Naeem-Ullah U, Bokhari SHM.Clinical Profiles of Dengue Fever Patients, during an Outbreak.J Arthropod Borne Dis. 2019;13(2):126-34.
Yogeesha KS, Sreejith MG, Sannegowda RB, Manjunath J, Arunachalam R. Clinical and laboratory parameters differentiating dengue from other causes of acute febrile illnesses in a tertiary care centre in South India. Int J Recent Trends Sci Technol. 2014;10(2):373-7.
Reller ME, Bodinayake C, Nagahawatte A, Devasiri V, Kodikara-Arachichi W, Strouse JJ et al. Unsuspected dengue and acute febrile illness in rural and semi urban southern Sri Lanka. Emerg Infect Dis. 2012; 18 (2): 256-63.
Luvira V, Silachamroon U, Piyaphanee W, Lawpoolsri S, Chierakul W, Leaungwutiwong P et al. Etiologies of Acute Undifferentiated Febrile Illness in Bangkok, Thailand.Am J Trop Med Hyg. 2019 Mar;100(3):622-9.
Muller DA, Depelsenaire AC1, Young PR3. Clinical and Laboratory Diagnosis of Dengue Virus Infection.J Infect Dis. 2017;215(suppl_2):S89-S95.
Souza LJ, Pressanha LB, Mansur LC, Souza LA, Ribeiro MB, Silveira Mdo V, Souto Filho JT. Comparison of clinical and laboratory characteristics between children and adults with dengue. Braz J Infect Dis. 2013; 17(1): 27-31.
Punjabi NH, Taylor WR, Murphy GS, Purwaningsih S, Picarima H, Sisson J et al. Etiology of acute, non-malaria, febrile illness in Jayapura, northeastern Papua, Indonesia. Am J Trop Med Hyg. 2012; 86(1):46-51.
Teixeira LAS1, Nogueira FPDS1, Nascentes GAN2. Prospective study of patients with persistent symptoms of dengue in Brazil. Rev Inst Med Trop Sao Paulo. 2017; doi: 10.1590/S1678-9946201759065. doi:10.1590/S1678-9946201759065
Quinn EJ, Cheong AH, Calvert JK, Higgins G, Hahesy T. Clinical Features and Laboratory Findings of Travelers Returning to South Australia with Dengue Virus Infection. Trop Med Infect Dis. 2018;3(1):e6.
Thaver AM, Sobani ZA, Qazi F, Khan M, Zafar A, Beg MA. Assessing the need for training: general practitioners' knowledge, attitude and practice concerning dengue and malaria in Karachi, Pakistan. Int Health. 2011;3(2):126-30.
sOtu A, Ebenso B, Etokidem A, Chukwuekezie O. Dengue fever - an update review and implications for Nigeria, and similar countries.[with ref 7,clinical symp]Afr Health Sci. 2019;19(2):2000-7.
Potts JA1, Gibbons RV, Rothman AL, Srikiatkhachorn A, Thomas SJ, Supradish POet al. Prediction of Dengue Disease Severity among Pediatric Thai Patients Using Early Clinical Laboratory Indicators. PLoS Negl Trop Dis. 2010;4(8):e769.
de Azeredo EL, Monteiro RQ, de-Oliveira Pinto LM. Thrombocytopenia in Dengue: Interrelationship between Virus and the Imbalance between Coagulation and Fibrinolysis and Inflammatory Mediators. Mediators Inflamm. 2015; https://doi.org/10.1155/2015/313842. doi:10.1155/2015/313842
Kalayanarooj S1, Vaughn DW, Nimmannitya S, Green S, Suntayakorn S, Kunentrasai N et al.Early Clinical and Laboratory Indicators of Acute Dengue Illness. J Infect Dis. 1997;176(2):313-21.
Hasan SR, Riaz M, Jafri FA.Characteristics and outcome of dengue infection; clinical perspective from a secondary care hospital of Karachi. Pak J Med Sci. 2013; 29(1): 115-8.
Thein TL, Lye DC, Leo YS, Wong JG, Hao Y, Wilder-Smith A. Severe Neutropenia in Dengue Patients: Prevalence and Significance. Am J Trop Med Hyg. 2014;90(6):984-7.
Chatterjee N, Mukhopadhyay M, Ghosh S, Mondol M, Das C, Patar K. An observational study of dengue fever in a tertiary care hospital of eastern India. J Assoc Physicians India. 2014;62(3):224-7.

Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2024 Journal of Pakistan Society of Internal Medicine.

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[1] Ho TS, Wang SM, Lin YS, Liu CC. Clinical and laboratory predictive markers for acute dengue infection. J Biomed Sci.2013;20(1): 75.

[2] Bos S1, Gadea G1, Despres P1. Dengue. A growing threat requiring vaccine development for disease prevention. Pathog Glob Health. 2018;112(6):294-305.

[3] Jameel T, Mehmood K, Mujtaba G, Choudhry N, Afzal N, Paul RF. Changing haematological parameters in dengue viral infections. J Ayub Med Coll Abbottabad. 2012; 24 (1):3-6.

[4] Sabat J1, Subhadra S1, Thakur B1, Panda M1, Panda S1, Pati SS1, Ho LM1, Dixit S1, Rathore SK1, Kar SK2, Dwibedi B3.Molecular and phylogenetic analysis of the dengue strains circulating in Odisha, India.Virusdisease. 2019;30(3):380-6.

[5] Saba S, Khan AUR, Naeem-Ullah U, Bokhari SHM.Clinical Profiles of Dengue Fever Patients, during an Outbreak.J Arthropod Borne Dis. 2019;13(2):126-34.

[6] Yogeesha KS, Sreejith MG, Sannegowda RB, Manjunath J, Arunachalam R. Clinical and laboratory parameters differentiating dengue from other causes of acute febrile illnesses in a tertiary care centre in South India. Int J Recent Trends Sci Technol. 2014;10(2):373-7.

[7] Reller ME, Bodinayake C, Nagahawatte A, Devasiri V, Kodikara-Arachichi W, Strouse JJ et al. Unsuspected dengue and acute febrile illness in rural and semi urban southern Sri Lanka. Emerg Infect Dis. 2012; 18 (2): 256-63.

[8] Luvira V, Silachamroon U, Piyaphanee W, Lawpoolsri S, Chierakul W, Leaungwutiwong P et al. Etiologies of Acute Undifferentiated Febrile Illness in Bangkok, Thailand.Am J Trop Med Hyg. 2019 Mar;100(3):622-9.

[9] Muller DA, Depelsenaire AC1, Young PR3. Clinical and Laboratory Diagnosis of Dengue Virus Infection.J Infect Dis. 2017;215(suppl_2):S89-S95.

[10] Souza LJ, Pressanha LB, Mansur LC, Souza LA, Ribeiro MB, Silveira Mdo V, Souto Filho JT. Comparison of clinical and laboratory characteristics between children and adults with dengue. Braz J Infect Dis. 2013; 17(1): 27-31.

[11] Punjabi NH, Taylor WR, Murphy GS, Purwaningsih S, Picarima H, Sisson J et al. Etiology of acute, non-malaria, febrile illness in Jayapura, northeastern Papua, Indonesia. Am J Trop Med Hyg. 2012; 86(1):46-51.

[12] Teixeira LAS1, Nogueira FPDS1, Nascentes GAN2. Prospective study of patients with persistent symptoms of dengue in Brazil. Rev Inst Med Trop Sao Paulo. 2017; doi: 10.1590/S1678-9946201759065. doi:10.1590/S1678-9946201759065

[13] Quinn EJ, Cheong AH, Calvert JK, Higgins G, Hahesy T. Clinical Features and Laboratory Findings of Travelers Returning to South Australia with Dengue Virus Infection. Trop Med Infect Dis. 2018;3(1):e6.

[14] Thaver AM, Sobani ZA, Qazi F, Khan M, Zafar A, Beg MA. Assessing the need for training: general practitioners' knowledge, attitude and practice concerning dengue and malaria in Karachi, Pakistan. Int Health. 2011;3(2):126-30.

[15] sOtu A, Ebenso B, Etokidem A, Chukwuekezie O. Dengue fever - an update review and implications for Nigeria, and similar countries.[with ref 7,clinical symp]Afr Health Sci. 2019;19(2):2000-7.

[16] Potts JA1, Gibbons RV, Rothman AL, Srikiatkhachorn A, Thomas SJ, Supradish POet al. Prediction of Dengue Disease Severity among Pediatric Thai Patients Using Early Clinical Laboratory Indicators. PLoS Negl Trop Dis. 2010;4(8):e769.

[17] de Azeredo EL, Monteiro RQ, de-Oliveira Pinto LM. Thrombocytopenia in Dengue: Interrelationship between Virus and the Imbalance between Coagulation and Fibrinolysis and Inflammatory Mediators. Mediators Inflamm. 2015; https://doi.org/10.1155/2015/313842. doi:10.1155/2015/313842

[18] Kalayanarooj S1, Vaughn DW, Nimmannitya S, Green S, Suntayakorn S, Kunentrasai N et al.Early Clinical and Laboratory Indicators of Acute Dengue Illness. J Infect Dis. 1997;176(2):313-21.

[19] Hasan SR, Riaz M, Jafri FA.Characteristics and outcome of dengue infection; clinical perspective from a secondary care hospital of Karachi. Pak J Med Sci. 2013; 29(1): 115-8.

[20] Thein TL, Lye DC, Leo YS, Wong JG, Hao Y, Wilder-Smith A. Severe Neutropenia in Dengue Patients: Prevalence and Significance. Am J Trop Med Hyg. 2014;90(6):984-7.

[21] Chatterjee N, Mukhopadhyay M, Ghosh S, Mondol M, Das C, Patar K. An observational study of dengue fever in a tertiary care hospital of eastern India. J Assoc Physicians India. 2014;62(3):224-7.