Effectiveness of platelet transfusion in dengue fever: Rangpur community medical college and hospital experience at Rangpur, Bangladesh
Keywords:Effectiveness, Platelet transfusion, Dengue fever
Background: Dengue fever, caused by the dengue virus and transmitted by mosquitoes, is a global health concern, causing mild to severe illness. Severe cases lead to thrombocytopenia, a low platelet count that can cause bleeding. Platelet transfusion is debated as a treatment strategy; some studies support its use to prevent bleeding, while others raise concerns about side effects. The aim of the study is to see the effectiveness of platelet transfusion in dengue patients who has a very low platelet count.
Methods: This single-center study was conducted at The Department of Medicine, Rangpur Community Medical College and Hospital, Bangladesh. A total of 52 patients were enrolled and analyzed in this study from March to August 2023.
Results: Most cases are Dengue Fever (86.54%), followed by Dengue Hemorrhagic Fever Grade 1 (7.69%) and Dengue Shock Syndrome (5.77%). Bleeding occurred in 15.38% of enrollment. Common symptoms include fever (78.85%), headache (57.69%), cough (67.31%), and myalgia (55.77%). Health parameters include blood pressure (110/70 mm Hg), pulse rate (86.5±12.8 bpm), and temperature (100.5±2.8°F). Investigation findings show S. bilirubin (0.61 mg/dl), S. creatinine (0.94 mg/dl), RBS (120.5 mg/dl), HB% (13.78 g/dl), and PCV (39.75). Platelet counts varied in different conditions, with most responders to platelet transfusion (94.23%) showing no deaths but adverse outcomes related to transfusion reactions (5.77%).
Conclusions: The prevalence of dengue fever in Bangladesh necessitates a comprehensive understanding of effective treatment modalities. By examining the outcomes and implications of platelet transfusion in this context, the research seeks to shed light on its effectiveness, thereby informing evidence-based medical practices and improving patient care.
Guzman MG, Halstead SB, Artsob H, Buchy P, Farrar J, Gubler DJ, et al. Dengue: a continuing global threat. Nature reviews microbiology. 2010;8(12):S7-16.
Halstead SB. Dengue. Lancet. 2007;370(9599):1644-52.
Nimmannitya S. Clinical spectrum and management of dengue haemorrhagic fever. Southeast Asian J Trop Med Public Health. 1987;18(3):392-7.
Mitrakul C, Poshyachinda M, Futrakul P, Sangkawibha N, Ahandrik S. Hemostatic and platelet kinetic studies in dengue hemorrhagic fever. Am J Trop Med Hygiene. 1977;26(5):975-84.
Mairuhu AT, Mac Gillavry MR, Setiati TE, Soemantri A, Ten Cate H, Brandjes DP, et al. Is clinical outcome of dengue-virus infections influenced by coagulation and fibrinolysis? A critical review of the evidence. Lancet Infect Dis. 2003;3(1):33-41.
Krishnamurti CH, Kalayanarooj SI, Cutting MA, Peat RA, Rothwell SW, Reid TJ, et al. Mechanisms of hemorrhage in dengue without circulatory collapse. Am J Trop Med Hygiene. 2001;65(6):840-7.
Dengue: guidelines for diagnosis, treatment, prevention and control. Available at: https://www.who.int. Accessed on 20 February 2023.
Rafi A, Mousumi AN, Ahmed R, Chowdhury RH, Wadood A, Hossain G. Dengue epidemic in a non-endemic zone of Bangladesh: clinical and laboratory profiles of patients. PLoS Neglect Trop Dis. 2020;14(10):e8567.
Rahman M, Rahman K, Siddque AK, Shoma S, Kamal AH, Ali KS, et al. First outbreak of dengue hemorrhagic fever, Bangladesh. Emerg Infect Dis. 2002;8(7):738.
Thomas R, Thambar RP, Pattupara AJ. Effect of platelet transfusion on bleeding complications in dengue fever: A retrospective study. J Trop Med. 2019.
Li W, Han X, Guo X. Platelet transfusion in adult patients with dengue: a retrospective study in a tertiary hospital. BMC Infect Dis. 2021.
Lin CF, Wan SW, Cheng HJ, Lei HY, Lin YS. Autoimmune pathogenesis in dengue virus infection. Viral Immunol. 2006;19(2):127-32.
Gupta S, Bansal S. Epidemiology and seropositivity of dengue fever cases in a tertiary care hospital of NCR in 2013. East J Med Sci. 2017;21:4-7.
Karoli R, Fatima J, Siddiqi Z, Kazmi KI, Sultania AR. Clinical profile of dengue infection at a teaching hospital in North India. J Infect Develop. 2012;6(07):551-4.
Kumar A, Rao CR, Pandit V, Shetty S, Bammigatti C, Samarasinghe CM. Clinical manifestations and trend of dengue cases admitted in a tertiary care hospital, Udupi district, Karnataka. Indian J Community Med. 2010;35(3):386.
Ukey PM, Bondade SA, Paunipagar PV, Powar RM, Akulwar SL. Study of seroprevalence of dengue fever in central India. Indian J Community Med. 2010;35(4):517.
Lai PC, Lee SS, Kao CH, Chen YS, Huang CK, Lin WR, et al. Characteristics of a dengue hemorrhagic fever outbreak in 2001 in Kaohsiung. J Microbiol Immunol Infect. 2004;37(5):266-70.
Jain P, Kuber D, Garg AK, Sharma GD, Agarwal AK. Manifestations of dengue fever: A hospital based study. J Indian Acad Clin Med. 2015;16(3):204-8.
Ahmed S, Arif F, Yahya Y, Rehman A, Abbas K, Ashraf S, Akram DS. Dengue fever outbreak in Karachi 2006 a study of profile and outcome of children under 15 years of age. JPMA. 2008;58(1):4.
Joshi R, Bai V. Profile of dengue patients admitted to a tertiary care hospital in Mumbai. Turkish J Pediatr. 2011;53(6):626.
Khan NA, Azhar EI, El-Fiky S, Madani HH, Abuljadial MA, Ashshi AM, et al. Clinical profile and outcome of hospitalized patients during first outbreak of dengue in Makkah, Saudi Arabia. Acta Tropica. 2008;105(1):39-44.
Schiffer CA, Anderson KC, Bennett CL, Bernstein S, Elting LS, Goldsmith M, et al. Platelet transfusion for patients with cancer: clinical practice guidelines of the American Society of Clinical Oncology. J Clin Oncol. 2001;19(5):1519-38.
Carr JM, Kruskall MS, Kaye JA, Robinson SH. Efficacy of platelet transfusions in immune thrombocytopenia. Am J Med. 1986;80(6):1051-4.
Elting LS, Goldsmith M. Trial to reduce alloimmunization to platelets study group. leukocyte reduction and ultraviolet b irradiation of platelets to prevent alloimmunization and refractoriness to platelet transfusions. New Eng J Med. 1997;337(26):1861-70.
Slichter SJ, Kaufman RM, Assmann SF, McCullough J, Triulzi DJ, Strauss RG, et al. Dose of prophylactic platelet transfusions and prevention of hemorrhage. New Eng J Med. 2010;362(7):600-13.