CHANGING HAEMATOLOGICAL PARAMETERS IN DENGUE VIRAL INFECTIONS
Abstract
Background: Dengue Fever is the most common arboviral disease in the world, and presents cyclicallyin tropical and subtropical regions of the world. The four serotypes of dengue virus, 1, 2, 3, and 4, forman antigenic subgroup of the flaviviruses (Group B arboviruses). Transmission to humans of any ofthese serotypes initiates a spectrum of host responses, from in apparent to severe and sometimes lethalinfections. Complete Blood count (CBC) is an important part of the diagnostic workup of patients.Comparison of various finding in CBC including peripheral smear can help the physician in bettermanagement of the patient. Material and Methods: This cross sectional study was carried out on aseries of suspected patients of Dengue viral infection reporting in Ittefaq Hospital (Trust). All wereinvestigated for serological markers of acute infection. Results Out of 341 acute cases 166 (48.7%)were confirmed by IgM against Dengue virus. IgG anti-dengue was used on 200 suspected re-infectedpatients. Seventy-one (39.5%) were positive and 118 (59%) were negative. Among 245 confirmeddengue fever patients 43 (17.6%) were considered having dengue hemorrhagic fever on the basis of laband clinical findings. Raised haematocrit, Leukopenia with relative Lymphocytosis and presenceatypical lymphocytes along with plasmacytoid cells was consistent finding at presentation in both thepatterns of disease, i.e., Dengue Haemorrhagic fever (DHF) and Dengue fever (DF). Conclusion:Changes in relative percentage of cells appear with improvement in the symptoms and recovery fromthe disease. These findings indicate that in the course of the disease, there are major shifts withincellular component of blood.Keywords: Dengue, Complete Blood count, atypical lymphocyteReferences
Gibbons RV, Vaughn DW. Dengue: An Escalating problem. BMJ
;324:1563–6.
Gubler DJ. The global emergence/resurgence of arboviral diseases
as public health problems. Arch Med Res 2002;33(4):330–42.
Ageep AK, Malik AA, Elkarsani MS. Clinical presentations and
laboratory findings in suspected cases of dengue virus. Saudi Med
J 2006;27:1711–3.
Guzman MG, Kouri G Dengue: an update. Lancet Infect Dis
;2(4)207–8
Gomber S, Ramachandran VG, Kumar S, Agarwal KN, Gupta
P, Gupta P, et al. Hematological observations as diagnostic
markers in dengue hemorrhagic fever--a reappraisal. Indian
Pediatr. 2001;38(5):477–81.
Chadwick D, Arch B, Wilder-Smith A, Paton N. Distinguishing
dengue fever from other infections on the basis of simple clinical
and laboratory features: application of logistic regression analysis.
J Clin Virol 2006;35:147–53.
J Ayub Med Coll Abbottabad 2012;24(1)
http://www.ayubmed.edu.pk/JAMC/24-1/Tahir.pdf
Itoda I, Masuda G, Suganuma A, Imamura A, Ajisawa A,Yamada
K, et al. Clinical features of 62 imported cases of dengue fever in
Japan. Am J Trop Med Hyg 2006;75:470–4.
Kalayanarooj S, Vaughn DW, Nimmannitya S, Green
S, Suntayakorn S, Kunentrasai N, et al. Early clinical and
laboratory indicators of acute dengue illness. J Infect Dis
;176(2):313–21.
La Russa VF, Innis BL. Mechanisms of dengue virus induced
bone marrow suppression. Baillieres Clin Haematol
;8(1):249–70.
Qureshi JA, Notta NJ, Salahuddin N, Zaman V, Khan JA. An
epidemic of dengue fever in Karachi: associated clinical
manifestations. J Pak Med Assoc 1997; 47:178–81.
Natasha Ali, Mohammad Usman, Naveen Syed, Mohammad
Khurshid. Haemorrhagic manifestations and utility of
haematological parameters in dengue fever: A tertiary care centre
experience at Karachi. Scandinavian Journal of Infectious
Diseases 2007;39(1112)1025–8
Riaz MM, Mumtaz K, Khan MS, Patel J, Tariq M, Hilal H, et al.
Outbreak of Dengue Fever in Karachi 2006. J Pak Med Assoc
;(6)231–5.
Lin SF, Liu HW, Chang CS, Yen JH, Chen TP. Hematological
aspects of dengue fever. Gaoxiong Yi Xue Ke Xue Za Zhi.
;5(1):12–6.
John M. Gawoski, Winnie W Ooi. Dengue Fever Mimicking
Plasma Cell Leukemia. Archives of Pathology and Laboratory
Medicine 2003;127(8)1026–7.
Wilder-Smith A, Schwartz E. Dengue in Travelers. N Engl J M
;353:924–32.
Carlos CC, Oishi K, Cinco MT, Mapua CA, Inoue S, Cruz DJ, et
al. Comparison of clinical features and hematologic
abnormalities between dengue fever and dengue hemorrhagic
fever among children in the philippines. Am J Trop Med Hyg
;73(2):435–440.
Beeson, PB, DA Bass. The eosinophile, In Smith LH. (ed.), Major
problems in internal medicine, Vol. 14. Philadelphia: WB
Saunders Co; 1977.p. 215–34.
Kamath SR, Ranjit S. Clinical features complications and atypical
manifestations of children with severe forms of dengue
hemorrhagic fever in South India. Indian J Pediatr 2006;73:889–95.
Pancharoen C, Thisyakorn U. Dengue virus infection during
infancy. Trans R Soc Trop Med Hyg 2001;95(3):307–8.
Diaz-Quijano FA, Villar-Centeno LA, Martinez-Vega RA.
Complications associated to severe thrombocytopenia in patients
with dengue. Rev Med Chil 2006;134:167–73.
Ostronoff M, Ostronoff F, Florêncio R, Florêncio M, Domingues
MC, Calixto R, et al Serious thrombocytopenia due to Dengue
Hemorrhagic Fever treated with high dosages of immunoglobulin
Clinical Inf Dis 2003;36:1623–24.
Mendez A, Gonzalez G. Abnormal clinical manifestations of
dengue hemorrhagic fever in children. Biomedica 2006;26:61–70.
Wills B, Oraqui EE, Stephens AC, Daramola OA, Dung
NM, Loan HT, et al. Coagulation abnormalities in dengue
hemorrhagic fever: serial investigations in 167 Vietnamese
children with dengue shock syndrome. Clin Infect Dis
;35:277–85.
Ali N, Nadeem A, Anwar M, Tariq W, Chotani RA. Dengue fever
in malaria endemic areas. J Coll Physicians Surg Pak
;16:340–2.
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