DENGUE FEVER

PREDICTORS OF SPONTANEOUS BLEEDING IN DENGUE FEVER

Abstract

Background: Dengue fever (DF) is a mosquito-transmitted disease caused by
the dengue virus, an enveloped, single stranded RNA virus of flaviridae family. DF is widely
distributed in many countries of southeast and southern Asia, Central and South America, and
the Western Pacific regions. Dengue fever (DF) has emerged as an epidemic in Pakistan for
the past few years. Objectives: To identify the predictive factors for spontaneous bleeding
manifestations in Dengue fever. Study Design: Descriptive case series. Settings: Pathology
department of King Edward Medical University and affiliated hospitals (Mayo Hospital and
Lady Aitchison Hospital). Study Period: Four months of dengue epidemic July-October 2011.
Material and Methods: This study included 125 patients with DF. Patients with spontaneous
bleeding were identified. Coagulation profile (including platelet count, prothrombin time
(PT) and activated partial thromboplastin time (APTT) were recorded in each group (With
and without bleeding). Results: Spontaneous bleeding during dengue fever occurred in
53(42.4%) patients. The mean coagulation profile in patients of dengue fever with and without
spontaneous bleeding was as follows: platelets (91.28±26.64X109/L versus 112.10±17.12 X
109/L, p<0.05), PT (15.72±2.42 versus 14.47±3.70 seconds, P>0.05), and APTT (41.0±24.00
versus 36.65±4.65 seconds), p<0.05). Conclusions: Frequency of spontaneous bleeding in
DF was high. A raised APTT and lower platelets counts was found in patients of dengue fever
with bleeding as compared to non bleeders while no difference in PT levels in both groups.