Abstract
<p class="Abstract">Bleeding manifestation in dengue cases presents due to the impairment of blood homeostasis. Previous studies mentioned that blood group O have higher bleeding risk because of lower blood coagulation von Willebran Factor (vWF) and factor VIII (FVIII) compared to non-O blood groups. This study was aiming to identify the comparison of blood group based on bleeding manifestation in pediatric dengue cases. The method used was a cross-sectional study with consecutive sampling in Pediatric Inpatient Ward Dr. Soetomo General Hospital, Surabaya, Indonesia, during March–September 2016. The study involved 86 dengue pediatric patients with 52 patients that fulfilled the inclusive criteria. The blood group, diagnosis, and the presence of bleeding manifestation data were collected from medical records and analyzed using chi-square test with p-value <0.05 and confidence interval 95 %. Blood group was divided based on ABO blood group system and based on blood group O and non-O. The results showed that there was no significant difference between ABO blood group based on the presence of bleeding manifestation (p = 0.579), and there was no significant difference between blood group O and non-O based on the presence of bleeding manifestation (p = 0.600). In this study, there was no significant difference between blood group based on bleeding manifestation in pediatric dengue cases. The previous bleeding risk theory based on blood coagulation factor was not proven based on this research.<o:p></o:p></p>
Highlights
Dengue infection is a self-limiting disease, its rapid and unpredictable clinical manifestation become the main cause on how the disease become worsen [1,2]
The data collected was from anamnesis, physical examination, blood group data, and patient complaints which were recorded in medical records
The conclusion of this study is, there was no significant difference between ABO blood group system with bleeding manifestation in dengue cases
Summary
Dengue infection is a self-limiting disease, its rapid and unpredictable clinical manifestation become the main cause on how the disease become worsen [1,2]. The clinical manifestation of dengue presents due to the impairment of blood homeostasis such as high hematocrite, low white blood cells, low neutrophils, high lymphocyte, low platelets, slightly prolonged activated partial. Patients with excessive depletion of intravascular volume from plasma leakage and/or massive bleeding from endothelial dysfunction (vasculopathy), thrombocytopenia, platelet dysfunction, and coagulopathy may exhibit shock, prolonged shock and repeated shock. The manifestation of vasculopathy are petechial, positive Rumple-Leed test, and the increase of vascular permeability causing the mediators release that leading to plasma, electrolyte, and protein leakage into the extravascular space. While the manifestation of thrombocytopenia and coagulopathy is bleeding in many forms, such as epistaxis, hematemesis, or melena [2,3,4]
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