Thrombocytopenia and bleeding manifestations among patients with dengue virus infection in Port Sudan, Red Sea State of Sudan

Abstract

Dengue is a global endemic and most prevalent human arbovirus disease. This study aimed at evaluating thrombocytopenia and to find out platelet activation in dengue across the spectrum of the disease. A prospective study was conducted from February, 2013 to June, 2014 at Port Sudan Teaching Hospital, Red Sea State, Sudan. 334 cases of dengue caused by dengue virus along with 101 cases of control were enrolled. Laboratory-positive dengue cases were confirmed by immune chromatography and World Health Organization (WHO) criteria were used for classifying the dengue severity. Platelet counts (PLT) and platelet distribution width (PDW) were measured. Out of 334, 289 patients had dengue fever (DF) and 45 patients had dengue haemorrhagic fever (DHF). Thrombocytopenia was present in 234 (81%) DF cases and 45 (100%) DHF cases. Bleeding manifestation was seen in 35 (10.5%) patients. Haematuria (5.7%), haematamesis (0.3%), haemoptysis (0.3%), epistaxis (1.5%), and gum bleed (2.7%) are the common forms of bleeding. PLT and PDW were found to be significantly low and high in case of dengue (P < 0.000), respectively. Thrombocytopenia (low PLT) and high PDW shows considerable sensitivity for dengue virus infection.