Abstract
Dengue fever associated with extreme reactive thrombocytosis
Highlights
Dengue is an important viral illness which has the potential to progress into dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS)
The mechanisms involved in thrombocytopenia and bleeding during dengue virus (DENV) infection is not fully understood
The concentration of circulating TPO is abnor-mally high in reactive thrombocytosis similar to auto-immune diseases, infections, or malignancies
Summary
Dengue is an important viral illness which has the potential to progress into dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). Leucopenia and throm-bocytopenia are the hallmarks of acute dengue which normalise with recovery [1]. We describe a patient presenting with acute dengue, who developed extreme reactive thrombocytosis. The platelet count progressively declined from 249×103/μl on 2nd day to 104×103/μl on 7th day of illness. The patient recovered and went home on the 9th day of illness with a platelet count of 154×103/μl. The patient presented with fatigue and breathlessness. The platelets remained persistently elevated for two weeks with the maximum recorded at 1015×103/μl. The platelets remained elevated above 500×103/μl for 14 more days, gradually declined and normalised to 452×1033/μl. Clopidogrel was discontinued after normalisation of platelets. The patient was asymptomatic and had normal blood counts
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