A Correlation of the Platelet Count with D-Dimer Levels as an Indicator for Component Therapy in Children with Dengue Hemorrhagic Fever
| Autor: | Aarathi R. Rau, Arthi Sridhar, Arne Rau, B. M. Sunil Kumar |
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| Rok vydání: | 2016 |
| Předmět: |
Disseminated intravascular coagulation
Clotting factor medicine.medical_specialty Hematology business.industry virus diseases 030204 cardiovascular system & hematology medicine.disease Gastroenterology Dengue fever 03 medical and health sciences 0302 clinical medicine hemic and lymphatic diseases Internal medicine Shock (circulatory) Immunology D-dimer Medicine Original Article Platelet medicine.symptom business Prospective cohort study 030215 immunology |
| Zdroj: | Indian Journal of Hematology and Blood Transfusion. 33:222-227 |
| ISSN: | 0974-0449 0971-4502 |
| Popis: | Dengue Fever (DF) may evolve into two life threatening forms—Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS). DHF is associated with increased vascular permeability and plasma leakage causing thrombocytopenia and loss of clotting factors into the third space and may result in bleeding initially due to thrombocytopenia and later due to disseminated intravascular coagulation (DIC), often as a terminal event. Prompt recognition and treatment of minor bleeds in DF children with incipient DIC with component therapy may be associated with improved survival while failure to do so is usually catastrophic. A sensitive marker for early DIC is the presence of D-dimer (DD) in the blood. To determine the correlation between the severity of thrombocytopenia and early DIC in children with DHF. The impact of additional factors like age and shock will also be evaluated. Case control prospective study of 60 DHF sero -positive children (1–15 years) with thrombocytopenia. After clinical evaluation they were divided into two equal groups based on the degree of thrombocytopenia (more than/less than 30,000/mm3). PT/APTT and DD levels were estimated in all children of both groups and statistical correlation was done. There was no significant difference in the DD levels between the two groups. However, children in either group, presenting with clinical features of shock and thrombocytopenia had significantly higher DD levels. Empirical component therapy in children with DHF based purely on their low platelet counts may not be justified. However, in DHF children with thrombocytopenia and features of shock, aggressive component therapy may prevent subsequent bleeding and may be justified. |
| Databáze: | OpenAIRE |
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