Is low platelet a predictor of dengue-related death or severity? A study by AIIMS and the National Institute of Virology (NIV) in Pune has questioned this common belief. The study concludes that platelet count neither influences disease outcome in dengue patients, nor does it correlate with rash or bleeding manifestations.
The report, published in a recent issue of Open Forum Infectious Diseases (OPID), is based on an analysis of clinical and laboratory characteristics of 369 dengue patients admitted to AIIMS between August and November 2015.
Doctors found that 10% of patients had bleeding manifestation, which is deadly , even when their platelet counts were normal. In contrast, 15 patients had no bleeding even with less than 10,000mm3 platelet count, which is considered very low.
Dr S K Sharma, the corresponding author of the AIIMS study , told TOI platelet count must be seen in correlation with clinical symptoms. “If the patient is stable, there is no need for transfusion even when the counts are less,” he added. Dr Sharma, now retired, headed AIIMS medicine department in 2015, when the statistical analysis started.
Platelet is a blood component that helps in clotting.Normal platelet count in human beings ranges between 1.5 and 4 lakh. In dengue fever, doctors say , there is increased destruction of platelets and reduction in the formation of new ones, which leads to low platelet count.
While transfusion in patients with very low platelet count and internal bleeding or rashes is important, preventive transfusion should be avoided, Dr Sanjeev Sinha, professor of medicine at AIIMS, said.
Study published in OPID states national guidelines (National Vector Borne Diseases Control Programme) recommends transfusion of platelets to asymptomatic patients with platelet counts below 10,000 mm3.
However, this is not based on supported scientific evidence and the World Health Organisation (WHO) also advocates against it.