IUse of Mean platelet Volume as an initial diagnostic marker in evaluation of dengue fever

Nabila Afsar,Shahmeen Humaira,Zakia Abid,Idrees Akhtar Afroze

doi:10.21276/apalm.1411

Nabila Afsar, Shahmeen Humaira + Show 2 more

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https://doi.org/10.21276/apalm.1411

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Abstract

Background: Dengue fever is the most rapidly spreading mosquito-borne viral disease. Four main characteristic manifestations of dengue illness are (i) continuous high fever lasting 2-7 days; (ii) haemorrhagic tendency as shown by a positive tourniquet test, petechiae or epistaxis; (iii) thrombocytopoenia (platelet count <100×109/l); and (iv) evidence of plasma leakage manifested by haemoconcentration (an increase in haematocrit 20% above average for age, sex and population), pleural effusion and ascites, etc. Recently, novel platelet indices such as MPV, PDW, and P-LCR have been investigated as prospective platelet activation markers .Platelet volume, a marker of platelet function and activity is measured as mean platelet volume (MPV) by hematology analyzer. Method: The study was done with the aim to assess whether mean platelet volume has any diagnostic importance in the initial evaluation of dengue fever . 45 adult patients were diagnosed with Dengue NS1 antigen positivity and underwent routine complete blood counts on automated hematology analyser HORIBA Pentra ES60. Result: A total of 76 cases ranging from 6 months to 50 years of age were reported as antigenically positive for dengue indicating acute infection, out of which 45 were adults ranging from 12 to 50 years of age. 34 were male and 11 were female. Infants and children below 12 years of age were not included in this study. 55 controls were studied which included 31 males and 24 females. The mean platelet volume was found to be significantly higher in dengue cases when compared to controls. MPV was also noted to be significantly higher in patients with platelet count below the normal biological reference range of 1.5 lakhs ,when compared to dengue patients with normal platelet counts. Conclusion: To conclude, high MPV indicates platelet activation and may be used as an initial marker to suspect dengue fever in a case of thrombocytopenia.

Highlights

Dengue fever is the most rapidly spreading mosquitoborne viral disease in the world
All four serotypes can cause the full spectrum of disease from a subclinical infection to a mild self limiting disease, the dengue fever (DF) and a severe disease that may be fatal, the dengue haemorrhagic fever/dengue shock syndrome (DHF/ DSS)
Four main characteristic manifestations of dengue illness are (i) continuous high fever lasting 2-7 days; (ii) haemorrhagic tendency as shown by a positive tourniquet test(Hess test or Rumpel-Leed capillary fragility test), petechiae or epistaxis; (iii) thrombocytopoenia; and (iv) evidence of plasma leakage manifested by haemoconcentration, pleural effusion and ascites, etc

Summary

Introduction

Dengue fever is the most rapidly spreading mosquitoborne viral disease in the world. An estimated 50 million infections per years occur across approximately 100 countries. Four main characteristic manifestations of dengue illness are (i) continuous high fever lasting 2-7 days; (ii) haemorrhagic tendency as shown by a positive tourniquet test(Hess test or Rumpel-Leed capillary fragility test), petechiae or epistaxis; (iii) thrombocytopoenia (platelet count

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