DOI: http://dx.doi.org/10.18203/2349-3933.ijam20175178

The total leucocyte count: its utility in dengue

Anagha A. Joshi, Gayathri B. R., Yashica Gowda R.

Abstract


Background: Dengue infections are public health concerns in India, where they occur in epidemics and have a high mortality in the advanced stages. Clinical features are nonspecific, and diagnosis is supported by lab features. One of these lab tests include total leucocyte count-easily available, simple and cost effective which is useful in small rural set ups for early diagnosis and prognosis of dengue. The aim of this study is to analyse the total leucocyte count patterns in dengue and assess its utility as early marker of dengue and prognosticator of severe dengue.

Methods: A total of 132 serologically proven cases of dengue with total white cell counts (blood counts obtained by Automated hematology analyser) during November 2016 were analysed.

Results: In our study, most cases were noted in the younger age group with a male predominance. The range of total leucocyte count was 1.1x109 /l to 14.3x109/l. Most (55%) had normal counts, leucopenia was noted in 36%, had an equal distribution in all ages and both sexes. 82% had mild leucopenia,52% of leucopenia cases were associated with severe thrombocytopenia. Almost half (47%) of leucopenia cases were NS1 positive while only 15% were antibody positive.59% of NS1 positive had leucopenia in contrast to 13% of antibody positive cases. While leucopenia was mostly (55%) associated with neutrophilia, lymphocytosis was seen in 74% of cases with a normal leucocyte count.

Conclusions: Total leucocyte count is one of the simple, easily available, cost effective tests useful in small rural set ups for early diagnosis and prognosis in dengue and helps reduce the morbidity and mortality of dengue.


Keywords


Dengue fever, Leucopenia, Lymphocytosis, Thrombocytopenia

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References


Patel PM, Patel SK, Sabalpara MA, Shah CK, Shah NR. Study of hematological and biochemical changes in dengue fever at tertiary care hospital at Ahmedabad. Inter J Medic Sci Pub Heal. 2016;5(9):1934-6.

Meena KC, Jelia S, Meena S, Arif M, Ajmera D, Jatav VS. A study of hematological profile in dengue fever at tertiary care center, Kota Rajasthan, India. Inter J Adv in Medic. 2016;3(3):621-4.

Dongre T, Karmarkar P. Hematological Parameters and its utility in dengue–A prospective study. IOSR J Dent and Medic Sci. 2015;14(2):31-4.

Fazal F, Biradar S. Clinical and lab profile of Dengue fever. J Evidence based medicine and healthcare. 2015;2(9):1136-47.

Narayanan M, Aravind MA, Ambikapathy P, Prema R and Jeyapaul MP. Dengue Fever-Clinical and Laboratory Parameters Associated with Complications. Dengue Bulletin. 2003;27:08-115

Malavige GN, Fernando S, Fernando DJ, Seneviratne SL. Dengue viral infections. Postgraduate medical J. 2004;80(948):588-601.

Khatri K, Rajani A, Khalla AR. Plasmacytoid lymphocytes: a diagnostic clue to dengue infection. Int J Sci Res. 2016;5(3):1002-5.

Mehta RC, Goswami HM, Katara KR, Patel PS, Parikh UV, Vegad MM, et al. Importance of complete blood count and peripheral smear examination in early diagnosis of dengue patients. J Infectious Diseases Letters. 2013;2(1):22-4.

Jayashree K, Manasa GC, Pallavi P, Manjunath GV. Evaluation of platelets as predictive parameters in dengue fever. Ind J Hematol Blood Trans. 2011;27(3):127-30.

Pongpan S, Wisitwong A, Tawichasri C, Patumanond J. Prognostic indicators for dengue infection severity. Inter J Clinic Pedia. 2013;2(1):12-8.

Vulavala S, Reddy Y, Kamarthy P. Study of clinical and laboratory profile of dengue fever patients. Eur J Pharma Medic Res. 2016;3(11):613-6.

Dhir G, Dhir T, Suri V, Dhir D, Khatri K. Hematological and Serological test profile in dengue fever, dengue hemorrhagic fever and dengue shock syndrome in Bathinda region of Punjab. Scholars J Applied Medic Sci. 2015;3(8):2926-30.

Karyanti MR. Clinical manifestations and hematological and serological findings in children with dengue infection. Paediatrica Indonesiana. 2011;51(3):157-62.

Ledika MA, Setiabudi D, Dhamayanti M. Association between Clinical Profiles and Severe Dengue Infection in Children in Developing Country. Americ J Epidemiol Infec Dis. 2015;3(3):45-9.

Mishra S, Ramanathan R, Agarwalla SK. Clinical profile of dengue fever in children: a study from southern Odisha, India. Scientifica. 2016;2016.

Jayanthi HK, Tulasi SK. Correlation study between platelet count, leukocyte count, nonhemorrhagic complications, and duration of hospital stay in dengue fever with thrombocytopenia. J Fam Medic Prim care. 2016;5(1):120.

Ch. Manoj Kumar, K. S. Keerthi Vyas, Y. Sai Krishna. Clinical profile of dengue fever with severe thrombocytopenia and its complications: a retrospective study at a tertiary care hospital in South India. Inter J Res Medic Sci. 2017;5(5):1751-1755.

Patel K, Patel D, Das VK. Hematological Parameters and Its Utility in Dengue fever: A prospective study. International Journal of Science and Research (IJSR). 2016;5(4):1077-9

Achalkar GV. Dengue-A clinicopathological study. J Evolution of Medic Dent Sci. 2013;2(48):9380-5

Agrawal A, Pansuriya H, Dhruva G. Platelet count and hematocrit as early indicators in acute dengue illness. Int J Res Med. 2013;2(2):63.

Gajera VV, Sahu S, Dhar R. Study of hematological profile of dengue fever and clinical implications. Annuals of Applied Biosci. 2016;3(3):242-5.

Azin FR, Gonçalves RP, Pitombeira MH, Lima DM, Castelo Branco I. Dengue: profile of hematological and biochemical dynamics. Revista brasileira de hematologia e hemoterapia. 2012;34(1):36-41.

Verdeal JC, Costa Filho R, Vanzillotta C, Macedo GL, Bozza FA, Toscano L, et al. Guidelines for the management of patients with severe forms of dengue. Revista Brasileira de terapia intensiva. 2011;23(2):125-33.

Malathesha MK, Ashwini HN. Hematological manifestations in dengue fever-an observational study. J Evol Medi Dent Sci. 2014;3(9):2245-50.

Pongpan S, Wisitwong A, Tawichasri C, Patumanond J, Namwongprom S. Development of dengue infection severity score. ISRN pediatrics. 2013;2013.

Thanachartwet V, Oer-Areemitr N, Chamnanchanunt S, Sahassananda D, Jittmittraphap A, Suwannakudt P, et al. Identification of clinical factors associated with severe dengue among Thai adults: a prospective study. BMC infectious diseases. 2015;15(1):420.

Jakribettu RP, Boloor R, Thaliath A, George SY, George T, Rai MP, et al. Correlation of clinicohaematological parameters in paediatric dengue: a retrospective study. Journal of Tropical Medicine. 2015;2015.

Kauser MM, Kalavathi GP, Radadiya M, Karthik M, Afreen A, Kumaraswamy RC. A study of clinical and laboratory profile of Dengue fever in tertiary care hospital in central Karnataka, India. Global J Medic Res. 2014;14(5).

Kulkarni RD, Patil SS, Ajantha GS, Upadhya AK, Kalabhavi AS, Shubhada RM, et al. Association of platelet count and serological markers of dengue infection-importance of NS1 antigen. Ind J Medic Microbiol. 2011;29(4):359.

Cordeiro MT. Lab diagnosis for dengue. Revista do Instituto de Medicina Tropical de São Paulo. 2015;54(15):510-512.