Correlation of Clinicohaematological Parameters in Paediatric Dengue: A Retrospective Study

Abstract

Dengue is one of the arthropod-borne (arbo) viral diseases transmitted by female mosquito Aedes aegypti. Dengue fever has a wide spectrum of clinical presentation ranging from flu-like illness to severe complicated stage of dengue hemorrhagic fever leading to mortality. This was a retrospective study conducted in a tertiary care hospital in Coastal Karnataka, South India, to know the correlation between the clinical presentation and haematological parameters in the paediatric cases presented with dengue symptoms. A total of 163 paediatric cases who presented fever and dengue-like illness were included in the study. Of which, 69 were confirmed dengue patients. Critical analysis showed that there was a significant difference in the haematological parameters like total leucocyte count, percent differential leucocyte count, and platelets count, in the erythrocyte sedimentation rate (P < 0.05 to 0.0001). Additionally, when compared to nondengue patients, even the liver function and renal function parameters were significantly deranged (P < 0.05 to 0.0001). Stratification based on NS1, IgG, and IgM showed significant alterations in the haematological, hepatic, and renal parameters. With respect to the treatment a small percentage of patients, that is, 8% (4 patients), required platelet transfusion as their counts went below 20,000/μL. Two patients succumbed to their illness while three required ICU stay.

Retrospective study of clinical profile and outcome of pediatric dengue cases in a teaching hospital

“…7 Fever was the major presenting complaints (100%) in our study which is correlating with the majority of the earlier studies like Patil G et al (98.6%), Jakribettu R P et al (100%). [7][8][9] Vomiting is the next common presentation in our study (77%), which is not correlating with the study done by Mallhi et al (55.2%) and Jakribettu R P et al (42.03%). 9,10 Respiratory distress was the next common presentation (56.25%) in our study which is more higher than in other study done by Mallhi et al (17.7%).…”

“…[7][8][9] Vomiting is the next common presentation in our study (77%), which is not correlating with the study done by Mallhi et al (55.2%) and Jakribettu R P et al (42.03%). 9,10 Respiratory distress was the next common presentation (56.25%) in our study which is more higher than in other study done by Mallhi et al (17.7%). 10 Generalised weakness and myalgia was the presenting manifestation in 54.1% of children which is in correlation to study done by Nimmagadda S et al (54.6%).…”

“…Other studies done earlier like Jakribettu RP et.al (4984±302) also show leucopoenia. 9 Our study had leucopoenia at admission in 54.1% of children as compare to Mandal SK et al (29.73%) and Patil G et al (28.78%). 8,11 Mean HCT at admission noted was 35.79±4.8, lowest HCT after treatment 32.0±3.8 at discharge mean HCT was 35.24±3.0.which occurs due to haemo concentration which occurs during illness and decrease in haematocrit after treatment.…”

The total leucocyte count: its utility in dengue

“…27 The analysis of leucopenia cases associated with serology patterns showed that 22 of 37 NS1 positive cases (59%) had leucopenia whereas (13%) 7 of 51 antibody only (IgM/IgG) positive cases had leucopenia. This was in accordance with other studies.…”

“…3,28 NS 1 antigen is known to be a marker for early diagnosis of the disease and is detected from first day, followed by IgM at 3-5 days and IgG from 1st week onwards. 27,29,30 A few studies analysing thrombocytopenia with serology patterns also have observed a higher proportion of cases with thrombocytopenia in NS 1 positivity than with antibody positivity. 29 Thus, our study in association with serology suggests that leucopenia is an early marker of dengue and association of leucopenia with thrombocytopenia suggests that it could be one of the prognosticator of severe dengue.…”